Individual
DR. TIM LAUTENSCHLAEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
535 BARNHILL DR, RT 041, INDIANAPOLIS, IN 46202-5116
(317) 944-2524
(317) 944-2486
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01075804A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201319860
—
IN
Enumeration date
04/23/2010
Last updated
12/01/2020
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