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General NPI Number Information
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NPI Number | 1356410823
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Entity Type | Organization
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Legal Business Name | EVANSVILLE PSYCHIATRIC ASSOCIATES
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 2015 MAXWELL AVENUE
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City | EVANSVILLE
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State | IN
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Zip | 47711-4359
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Country | US
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Telephone | 812-422-7974
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Fax | 812-422-8163
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Provider Business Mailing Address
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Address Line | 2015 MAXWELL AVENUE
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City | EVANSVILLE
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State | IN
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Zip | 47711-4359
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Country | US
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Telephone | 812-422-7974
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Fax | 812-422-8163
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PATRICIA E BRUGGENSCHMIDT
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Credential | MHA
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Telephone | 812-422-7974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 01047200A
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License Number State | IN
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