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LAKE PEDIATRICS PC NPI 1619114097


NPI Information

NPI: 1619114097
Provider Name: LAKE PEDIATRICS PC

Doing Business As: OLD SCHOOLHOUSE PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
373 MERIDIAN PARKE LN
STE. E
GREENWOOD, IN
ZIP 46142
Phone: (317) 893-2364
Get Directions

LAKE PEDIATRICS PC is a pediatrics in Greenwood, IN. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. LAKE PEDIATRICS PC NPI is 1619114097. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Old Schoolhouse Pediatrics.

The provider's business location address is:

373 MERIDIAN PARKE LN
STE. E
GREENWOOD, IN
ZIP 46142-420
Phone: (317) 893-2364
Fax: (317) 851-8066

The provider's authorized official is Marjorie E Lake .
The authorized official title is Ceo/owner and has the following contact phone number (317) 893-2364.

The enumeration date for this NPI number is 1/7/2009 and was last updated on 3/26/2013.


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
1208000000XPediatricsYes

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
150005045AOTHERINDIANAMEDICAL CORPORATION LICENSE
2200928110AMEDICAIDINDIANA

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

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