Individual
MR. DOUGLAS JOHN LADIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
151 E BOW ST, THORNTOWN, IN 46071
(765) 436-2400
(765) 436-7375
Mailing address
2705 N LEBANON ST STE 305, LEBANON, IN 46052-8622
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000987A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300004507
—
IN
Enumeration date
09/19/2008
Last updated
04/28/2021
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