Organization
INDIANA UNIVERSITY HEALTH LA PORTE PHYSICIANS INC
Active
Other names
La Porte Regional Physician Network Inc
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN DONNELLY (VP OF STRATEGY & AMBULATORY SERVICE)
(219) 325-4682
Entity
Organization
Contact information
Practice address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-2489
(219) 326-2584
Mailing address
PO BOX 1690, LA PORTE, IN 46352-1690
(219) 326-2312
(219) 326-2584
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100165070
—
IN
05
—
200255890
—
IN
05
—
200988350
—
IN
Enumeration date
08/31/2006
Last updated
05/22/2014
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