Provider Demographics
NPI:1699194704
Name:MSO CLINICS, INC.
Entity Type:Organization
Organization Name:MSO CLINICS, INC.
Other - Org Name:CARLISLE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:812-268-4311
Mailing Address - Street 1:8685 OLD HIGHWAY 41 SOUTH
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:IN
Mailing Address - Zip Code:47838-8234
Mailing Address - Country:US
Mailing Address - Phone:812-398-5200
Mailing Address - Fax:812-398-5102
Practice Address - Street 1:8685 OLD HIGHWAY 41 SOUTH
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:IN
Practice Address - Zip Code:47838-8234
Practice Address - Country:US
Practice Address - Phone:812-398-5200
Practice Address - Fax:812-398-5102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SULLIVAN COUNTY COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-16
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201246990AMedicaid
IN15-3906Medicare PIN
IN153906Medicare Oscar/Certification