Individual
RYAN LINGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
900 I ST, LA PORTE, IN 46350-5533
(219) 324-1700
(219) 324-1602
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-1070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02006279
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300050152
—
IN
Enumeration date
03/26/2018
Last updated
04/28/2023
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