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Organization
LAFAYETTE WOMENS HEALTH
Active
Organization
LAFAYETTE WOMENS HEALTH
Active
Parent organization
LAFAYETTE WOMENS HEALTH
Other names
PREMIER HEALTHCARE FOR WOMEN
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAFAYETTE WOMENS HEALTH
Authorized official
ROBERT IDESON (ADMINISTRATOR)
(765) 428-5888
Entity
Organization
Contact information
Practice address
3774 BAYLEY DR, SUITE B, LAFAYETTE, IN 47905-8651
(765) 807-2280
(765) 807-2281
Mailing address
3774 BAYLEY DR, SUITE B, LAFAYETTE, IN 47905-8651
(765) 807-2280
(765) 807-2281
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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