# LA PORTE REGIONAL PHYSICIAN NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Med Spa Obstetrics & Gynecology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851593099
- **Authorized official:** RHONDA VOLK (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (219) 326-2485

## Contact information

- **Practice address:** 601 KIEFFER RD, MICHIGAN CITY, IN 46360
- **Practice address phone:** (219) 879-6262
- **Mailing address:** PO BOX 1690, LA PORTE, IN 46352-1690
- **Mailing address phone:** (219) 326-2312
- **Mailing address fax:** (219) 326-2584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 01052711 | IN | Yes |

## Other

- **Enumeration date:** 06/01/2007
- **Last updated:** 06/06/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100165070Z | — | IN |