Provider Demographics
NPI:1144298191
Name:PHYSICIANS' HEALTH GROUP, LLC
Entity type:Organization
Organization Name:PHYSICIANS' HEALTH GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUIVE 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 1:801 SAINT MARYS DR
Mailing Address - Street 2:SUITE 302-E
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0511
Mailing Address - Country:US
Mailing Address - Phone:812-485-4141
Mailing Address - Fax:812-485-4338
Practice Address - Street 1:801 SAINT MARYS DR
Practice Address - Street 2:SUITE 302-E
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0511
Practice Address - Country:US
Practice Address - Phone:812-485-4141
Practice Address - Fax:812-485-4338
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
IN207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000245593OtherUNICARE
066076OtherHEALTH ALLIANCE
168420OtherHEALTHLINK
IN000000245592OtherBCBS
CK5997OtherRAILROAD MEDICARE
066076OtherHEALTH ALLIANCE
168420OtherHEALTHLINK
=========07OtherDONLEY & CO.