Provider Demographics
NPI:1700837358
Name:INTEGRITY FAMILY PHYSICIANS, PC
Entity Type:Organization
Organization Name:INTEGRITY FAMILY PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THIMJON
Authorized Official - Middle Name:C
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-491-3236
Mailing Address - Street 1:6221 PHYSICIANS CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4031
Mailing Address - Country:US
Mailing Address - Phone:812-491-3236
Mailing Address - Fax:812-491-3242
Practice Address - Street 1:6221 PHYSICIANS CT
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4031
Practice Address - Country:US
Practice Address - Phone:812-491-3236
Practice Address - Fax:812-491-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50004404A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000227038OtherANTHEM INDIANA GRP NUMBER
IN3263OtherRR MEDICARE GRP NUMBER
IN000000227038OtherANTHEM INDIANA GRP NUMBER
IN3263OtherRR MEDICARE GRP NUMBER