Provider Demographics
NPI:1558681387
Name:HAND CENTER OF EVANSVILLE LLC
Entity Type:Organization
Organization Name:HAND CENTER OF EVANSVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MARBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-853-2720
Mailing Address - Street 1:1150 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-1071
Mailing Address - Country:US
Mailing Address - Phone:812-853-2720
Mailing Address - Fax:812-437-4263
Practice Address - Street 1:1150 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-1071
Practice Address - Country:US
Practice Address - Phone:812-853-2720
Practice Address - Fax:812-437-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201016970AMedicaid
IN6416590001Medicare NSC