Provider Demographics
NPI:1598829749
Name:OCCUPATIONAL MEDICINE PHYSICIANS
Entity Type:Organization
Organization Name:OCCUPATIONAL MEDICINE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PREOCANIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-754-1900
Mailing Address - Street 1:705 FAIRGROUND RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-6778
Mailing Address - Country:US
Mailing Address - Phone:812-754-1900
Mailing Address - Fax:812-754-1910
Practice Address - Street 1:2201 GREENTREE N
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-8957
Practice Address - Country:US
Practice Address - Phone:812-283-2013
Practice Address - Fax:812-283-2538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty
Not Answered363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Single Specialty