Organization
EAGLE CREEK DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INGRIDA IVETA OZOLS MD (PARTNER)
(317) 329-7050
Entity
Organization
Contact information
Practice address
6820 PARKDALE PL, SUITE 211, INDIANAPOLIS, IN 46254-6600
(317) 329-7050
(317) 328-6809
Mailing address
6820 PARKDALE PL, SUITE 211, INDIANAPOLIS, IN 46254-6600
(317) 329-7050
(317) 328-6809
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
01027554
IN
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
01024873
IN
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
01057248
IN
Other
Enumeration date
09/26/2008
Last updated
09/11/2013
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