Provider Demographics
NPI:1760450712
Name:PHYSICIANS' HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:PHYSICIANS' HEALTH GROUP, LLC
Other - Org Name:NEWBURGH PRIMARY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEINERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-485-1818
Mailing Address - Street 1:8077 ROSE HILL DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-2811
Mailing Address - Country:US
Mailing Address - Phone:812-853-7363
Mailing Address - Fax:812-858-5723
Practice Address - Street 1:8077 ROSE HILL DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2811
Practice Address - Country:US
Practice Address - Phone:812-853-7363
Practice Address - Fax:812-858-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207Q00000X
IN71001016A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000245579OtherBCBS
CK6301OtherRAILROAD MEDICARE
CK6301OtherRAILROAD MEDICARE
CK6301OtherRAILROAD MEDICARE