Provider Demographics
NPI:1205637576
Name:STURGIS CLINIC
Entity type:Organization
Organization Name:STURGIS CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICIAN ASSISTANT
Authorized Official - Phone:270-724-2260
Mailing Address - Street 1:412 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:KY
Mailing Address - Zip Code:42459-1630
Mailing Address - Country:US
Mailing Address - Phone:270-724-2260
Mailing Address - Fax:
Practice Address - Street 1:412 N MAIN ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:KY
Practice Address - Zip Code:42459-1630
Practice Address - Country:US
Practice Address - Phone:270-724-2260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-22
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care