Healthcare Provider Details

I. General information

NPI: 1073718326
Provider Name (Legal Business Name): UNION HOSPITAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S MAIN ST
CLINTON IN
47842-2261
US

IV. Provider business mailing address

PO BOX 2505
INDIANAPOLIS IN
46206-2505
US

V. Phone/Fax

Practice location:
  • Phone: 765-832-1234
  • Fax:
Mailing address:
  • Phone: 812-238-7783
  • Fax: 812-238-4506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: B JOLENE WHITAKER
Title or Position: BILLING MANAGER
Credential:
Phone: 812-238-4962