Individual
LORI L DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
107 N STATE ROAD 135, SUITE 102, GREENWOOD, IN 46142-1351
(317) 893-3131
(317) 893-3141
Mailing address
107 N STATE ROAD 135 STE 102, GREENWOOD, IN 46142-1352
(317) 893-3131
(317) 893-2445
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01037737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100194210A
—
IN
Enumeration date
07/29/2005
Last updated
02/21/2024
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