Organization
WARSAW HEALTH SYSTEM, LLC
Active
Other names
Northern Lakes Orthopaedics & Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HURLEY (SENIOR VICE PRESIDENT)
(214) 473-3993
Entity
Organization
Contact information
Practice address
3505 LAKE CITY HWY, WARSAW, IN 46580-3942
(574) 372-5823
Mailing address
PO BOX 996, WARSAW, IN 46581-0996
(574) 372-5823
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IN
Enumeration date
09/13/2006
Last updated
09/11/2025
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