LAKE PARK CLINIC P.C. NPI 1083810253

NPI Information

NPI: 1083810253
Provider Name: LAKE PARK CLINIC, P.C.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1356 S LAKE PARK AVE
HOBART, IN
ZIP 46342
Phone: (219) 942-8518
Get Directions

LAKE PARK CLINIC, P.C. is a family medicine in Hobart, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAKE PARK CLINIC, P.C. NPI is 1083810253. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1356 S LAKE PARK AVE
HOBART, IN
ZIP 46342-964
Phone: (219) 942-8518
Fax: (219) 947-2751

The provider's authorized official is Christine Jordan .
The authorized official title is Office Manager and has the following contact phone number (219) 942-1422.

The enumeration date for this NPI number is 6/25/2007 and was last updated on 6/13/2014.

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	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	471340B	MEDICARE PIN	INDIANA
2	000000086604	OTHER	INDIANA	BLUE CROSS BLUE SHIELD
3	100159850A	MEDICAID	INDIANA
4	011164281	MEDICARE PIN	INDIANA
5	47134001	MEDICARE PIN	INDIANA
6	000000550461	OTHER	INDIANA	ANTHEM
7	471340A	MEDICARE PIN	INDIANA

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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