Individual
PETER J LODICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4506 1ST AVE, EVANSVILLE, IN 47710-3324
(812) 428-6161
(812) 421-2883
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 428-6161
(812) 421-2883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01053255A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200908700
—
IN
Enumeration date
11/29/2005
Last updated
07/23/2013
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