Individual
LISA K LAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5500 S US HIGHWAY 41, TERRE HAUTE, IN 47802-4745
(812) 232-0564
(812) 242-3842
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 232-0564
(812) 242-3842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01061236A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000384966A
ANTHEM
—
01
—
351904269221
CARESOURCE MEDICAID
—
01
—
7014223
CIGNA
—
01
—
740329
HEALTHLINK
—
01
—
7411388
AETNA
—
01
—
P00315179
RAILROAD MCARE PALAMETTO
—
Enumeration date
08/29/2006
Last updated
09/26/2007
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