Organization
SIGMA MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LEASE (EXECUTIVE DIRECTOR)
(765) 775-2828
Entity
Organization
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 775-2828
(765) 775-2833
Mailing address
1415 SALEM ST, SUITE 302, LAFAYETTE, IN 47904-2099
(765) 449-2410
(765) 742-8607
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200495560
—
IN
Enumeration date
07/27/2006
Last updated
07/18/2011
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