| Lynn Pittman Do Internal Medicine Enterprise Llc | |
|
3363 N Pennsylvania St Indianapolis IN 46205-3415 | |
| (317) 924-4545 | |
| Not Available |
| Full Name | Lynn Pittman Do Internal Medicine Enterprise Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3363 N Pennsylvania St, Indianapolis, Indiana |
| Authorized Official Name and Position | Lynn Pittman (PHYSICIAN) |
| Authorized Official Contact | 8122414749 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynn Pittman Do Internal Medicine Enterprise Llc 3140 N Windmill Ct Terre Haute IN 47805-8627 Ph: (812) 241-4749 | Lynn Pittman Do Internal Medicine Enterprise Llc 3363 N Pennsylvania St Indianapolis IN 46205-3415 Ph: (317) 924-4545 |
| NPI Number | 1699296764 |
|---|---|
| Provider Enumeration Date | 06/29/2017 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 8426321738 |
|---|---|
| Medicare Enrollment ID | O20170908000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699296764 | NPI | - | NPPES |
| 200521340 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 02002857A (Indiana) | Primary |
| Provider Name | Lynn A Pittman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609840040 PECOS PAC ID: 8325096662 Enrollment ID: I20050104000524 |
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