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Individual

DR. LUKE PORTWOOD FIFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-6900
(812) 355-6912
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01087459A
IN
208600000X
Surgery Physician
48989
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100428850
KY
Enumeration date
04/16/2011
Last updated
08/23/2022
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