| Lafayette Gastroenterology | |
|
5 Executive Dr Suite B1 Lafayette IN 47905-3832 | |
| (765) 807-0531 | |
| (765) 807-0534 |
| Full Name | Lafayette Gastroenterology |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 5 Executive Dr, Lafayette, Indiana |
| Authorized Official Name and Position | Martha K Miller (DIRECTOR OF BILLING) |
| Authorized Official Contact | 7654465286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lafayette Gastroenterology Po Box 4699 Lafayette IN 47903-4699 Ph: (765) 446-5417 | Lafayette Gastroenterology 5 Executive Dr Suite B1 Lafayette IN 47905-3832 Ph: (765) 807-0531 |
| NPI Number | 1427143205 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 08/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427143205 | NPI | - | NPPES |
| 200107480 | Medicaid | IN | |
| 200476110 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Indiana) | Primary |
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Horizon Oncology Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1345 Unity Pl, Ste 365, Lafayette, IN 47905 Phone: 765-446-5111 Fax: 765-446-5165 | |
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