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Organization

LA PORTE REGIONAL PHYSICIAN NETWORK, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RHONDA VOLK (EXECUTIVE DIRECTOR)
(219) 326-2489
Entity
Organization

Contact information

Practice address
1300 STATE ST, SUITE 2A, LA PORTE, IN 46350-3185
(219) 325-3679
Mailing address
PO BOX 1690, LA PORTE, IN 46352-1690
(219) 326-2312
(219) 326-2584

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01033345
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100165070G
IN
Enumeration date
05/13/2009
Last updated
05/13/2009
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