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General NPI Number Information
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NPI Number | 1811075286
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Entity Type | Organization
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Legal Business Name | HUNTINGBURG MEDICAL CENTER, INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/02/2014
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Provider Practice Location Address
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Address Line | 1706 MEDICAL ARTS DR SUITE 3
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City | HUNTINGBURG
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State | IN
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Zip | 47542-9049
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Country | US
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Telephone | 812-683-4900
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Fax | 812-683-3206
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Provider Business Mailing Address
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Address Line | 1706 MEDICAL ARTS DR SUITE 3
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City | HUNTINGBURG
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State | IN
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Zip | 47542-9049
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Country | US
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Telephone | 812-683-4900
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Fax | 812-683-3206
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GWENDA L BRECKLER
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Credential | D.O.
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Telephone | 812-683-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02002504
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License Number State | IN
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