# DAWALT FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033131073
- **Authorized official:** JOSHUA DAWALT (OWNER)
- **Authorized official phone:** (317) 297-5145

## Contact information

- **Practice address:** 5645 LAFAYETTE RD, SUITE A, INDIANAPOLIS, IN 46254-1102
- **Practice address phone:** (317) 297-5145
- **Mailing address:** 5645 LAFAYETTE RD, SUITE A, INDIANAPOLIS, IN 46254-1102
- **Mailing address phone:** (317) 297-5145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02002880A | IN | Yes |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 02/02/2010