Individual
LYDIA H FERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6325 S EAST ST, INDIANAPOLIS, IN 46227-7110
(317) 781-0067
(317) 791-1242
Mailing address
PO BOX 3046, INDIANAPOLIS, IN 46206-3046
(317) 567-2180
(317) 614-9655
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01056802
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
01056802A
IN
208VP0000X
Pain Medicine Physician
Primary
01056802A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000571185
ANTHEM
IN
05
—
200526170
—
IN
Enumeration date
09/01/2005
Last updated
04/05/2012
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