Organization
HIGH RISK OBSTETRICS & DIAGNOSTICS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS ALLAN LOSURE DO (PRESIDENT HIGH RISK OB)
(219) 213-2280
Entity
Organization
Contact information
Practice address
1205 S MAIN ST, SUITE 203, CROWN POINT, IN 46307-3676
(219) 213-2280
(219) 213-2280
Mailing address
1205 S MAIN ST, SUITE 203, CROWN POINT, IN 46307-3676
(219) 213-2280
(219) 213-2280
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036058922
LICENSE
IL
01
—
036076900
LICENSE
IL
Enumeration date
10/25/2006
Last updated
09/22/2016
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