Organization · Type 2 NPI
Innovative Medicine
Addiction Medicine (Family Medicine) Physician · Lafayette, IN
NPI number
1417486523
Active
Practice location
3554 Promenade Pkwy Ste H
Lafayette, IN 47909-8418
Fax (765) 471-1009
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Family Medicine) Physician Primary | 207QA0401X | None listed |
| Adult Medicine Physician | 207QA0505X | None listed |
| Obesity Medicine (Family Medicine) Physician | 207QB0002X | None listed |
| Non-Pharmacy Dispensing Site | 332900000X | None listed |
Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.
Another provider at this address
About NPI 1417486523
Innovative Medicine's National Provider Identifier is 1417486523, issued on Jun 12, 2017. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Lafayette, IN. The record was last updated on Apr 18, 2024.