# LIFEPLEX MEDICAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifePlex Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114449238
- **Authorized official:** BYRON HOLM MD (MD)
- **Authorized official phone:** (574) 936-7777

## Contact information

- **Practice address:** 2855 MILLER DR STE 117, PLYMOUTH, IN 46563-8091
- **Practice address phone:** (574) 936-7777
- **Practice address fax:** (574) 941-1072
- **Mailing address:** 2855 MILLER DR STE 117, PLYMOUTH, IN 46563-8091
- **Mailing address phone:** (574) 936-7777
- **Mailing address fax:** (574) 941-1072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01024911A | IN | Yes |
| 261QU0200X | Urgent Care Clinic/Center | — | IN | — |

## Other

- **Enumeration date:** 07/11/2017
- **Last updated:** 05/25/2021