Individual
DAVID J LICINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1302 S ROGERS ST, BLOOMINGTON, IN 47403-4752
(812) 333-2663
(812) 676-4131
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01071339A
IN
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
01071339A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201119230
—
IN
Enumeration date
07/31/2007
Last updated
10/27/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us