Provider Demographics
NPI:1760902993
Name:UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Entity Type:Organization
Organization Name:UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Other - Org Name:UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REV CYC DIR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-232-0564
Mailing Address - Street 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-232-0564
Mailing Address - Fax:812-242-3861
Practice Address - Street 1:1 ST MARY OF WOODS COLL
Practice Address - Street 2:
Practice Address - City:SAINT MARY OF THE WOODS
Practice Address - State:IN
Practice Address - Zip Code:47876-1098
Practice Address - Country:US
Practice Address - Phone:812-232-0564
Practice Address - Fax:812-242-3861
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION ASSOCIATED PHYSICIANS CLINIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty