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Individual

LISA M LANDRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
535 BARNHILL DR, INDIANAPOLIS, IN 46202-5116
(317) 948-7583
(317) 968-1118
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
01086334A
IN
207V00000X
Obstetrics & Gynecology Physician
01086334A
IN
207VX0201X
Gynecologic Oncology Physician
Primary
01086334A
IN
207VX0201X
Gynecologic Oncology Physician
22924
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001560650
ANTHEM PTAN
IN
05
300052935
IN
Enumeration date
08/20/2006
Last updated
03/13/2025
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