Individual
JOSE ANTONIO LUSANCAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5500 HOHMAN AVE, HAMMOND, IN 46320-1965
(219) 401-2969
Mailing address
5500 HOHMAN AVE, HAMMOND, IN 46320-1965
(219) 401-2969
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01093411A
IN
207Q00000X
Family Medicine Physician
TEM-COV19-20639
IL
208D00000X
General Practice Physician
ACN485
FL
Other
Enumeration date
08/05/2010
Last updated
01/06/2026
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