Individual
LISA A YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
690 W NORTHFIELD DR STE 200, BROWNSBURG, IN 46112-7504
(317) 779-1466
Mailing address
690 W NORTHFIELD DR STE 200, BROWNSBURG, IN 46112-7504
(317) 779-1466
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01042167
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100463820
—
IN
Enumeration date
07/11/2006
Last updated
12/11/2020
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