Dr Lylan S Park, MD | |
2600 Greenbush St, Lafayette, IN 47904-2477 | |
(765) 448-8000 | |
Not Available |
Full Name | Dr Lylan S Park |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2600 Greenbush St, Lafayette, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043243561 | NPI | - | NPPES |
000000808598 | Other | IN | ANTHEM PROVIDER NUMBER |
201145160 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 01052774A (Indiana) | Primary |
208000000X | Pediatrics | 036-099146 (Illinois) | Secondary |
Entity Name | Arnett Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164490843 PECOS PAC ID: 0749184380 Enrollment ID: O20031125000119 |
Mailing Address | Practice Location Address |
---|---|
Dr Lylan S Park, MD 1200 W White River Blvd, Muncie, IN 47303-4988 Ph: (877) 668-5621 | Dr Lylan S Park, MD 2600 Greenbush St, Lafayette, IN 47904-2477 Ph: (765) 448-8000 |
Linnette Sue Maier Woodman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-448-8227 | |
Christopher O Wood, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 | |
Sabeena Rana Hubbard, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 2600 Ferry St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-838-4698 | |
Lauren E Winsauer, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2600 Ferry St, Lafayette, IN 47904 Phone: 765-448-8000 | |
Theresa Anne Woods, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2600 Ferry St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-448-7611 | |
Nadeem Abbasi, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 Fax: 765-868-6302 |