Organization
LAFAYETTE WOMANS HEALTH
Active
Parent organization
LAFAYETTE WOMANS HEALTH
Other names
LAFAYETTE OBSTETRICS AND GYNECOLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAFAYETTE WOMANS HEALTH
Authorized official
ROBERT IDESON (PRACTICE MANAGER)
(765) 428-5888
Entity
Organization
Contact information
Practice address
3920 ST FRANCIS WAY, SUITE 110, LAFAYETTE, IN 47905-4917
(765) 428-5800
(765) 428-5802
Mailing address
3920 ST FRANCIS WAY, SUITE 110, LAFAYETTE, IN 47905-4917
(765) 428-5800
(765) 428-5802
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200303310A
—
IN
Enumeration date
07/07/2006
Last updated
10/04/2011
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