PROACTIVE MSO LLC NPI 1033662820

NPI Information

NPI: 1033662820
Provider Name: PROACTIVE MSO, LLC

Doing Business As: SPENCER HEALTH CENTER

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 15D2091875

Address:
630 W STATE HIGHWAY 46
SPENCER, IN
ZIP 47460
Phone: (812) 828-7596
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PROACTIVE MSO, LLC is a primary care clinic center in Spencer, IN. PROACTIVE MSO, LLC NPI is 1033662820. The provider is registered as an organization entity type.
The provider Is Doing Business As Spencer Health Center.

The provider's business location address is:

630 W STATE HIGHWAY 46
SPENCER, IN
ZIP 47460-439
Phone: (812) 828-7596

The provider's authorized official is Jan Hopkins .
The authorized official title is Assoc. Ops Manager and has the following contact phone number (864) 501-0751.

The CLIA number assigned to this NPI record is 15D2091875 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2016 and was last updated on 3/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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