Provider Demographics
NPI:1558571067
Name:GENE E RESS M.D. PSC
Entity Type:Organization
Organization Name:GENE E RESS M.D. PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-971-8222
Mailing Address - Street 1:2127 TELL ST
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-2549
Mailing Address - Country:US
Mailing Address - Phone:812-971-8222
Mailing Address - Fax:812-359-4481
Practice Address - Street 1:2127 TELL ST
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-2549
Practice Address - Country:US
Practice Address - Phone:812-971-8222
Practice Address - Fax:812-359-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000187499OtherBLUE CROSS
IN000000187499OtherBLUE CROSS
INB29242Medicare UPIN