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MD ORTHOTIC AND PROSTHETIC LABORATORIES INC. NPI 1932153418


NPI Information

NPI: 1932153418
Provider Name: MD ORTHOTIC AND PROSTHETIC LABORATORIES, INC.
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
9521 INDIANAPOLIS BLVD
SUITE B
HIGHLAND, IN
ZIP 46322
Phone: (219) 736-8896
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MD ORTHOTIC AND PROSTHETIC LABORATORIES, INC. is a prosthetic orthotic supplier in Highland, IN. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. MD ORTHOTIC AND PROSTHETIC LABORATORIES, INC. NPI is 1932153418. The provider is registered as an organization entity type.

The provider's business location address is:

9521 INDIANAPOLIS BLVD
SUITE B
HIGHLAND, IN
ZIP 46322
Phone: (219) 736-8896
Fax: (888) 635-3135

The provider's authorized official is Donald Goertzen .
The authorized official title is President and has the following contact phone number (309) 676-2276.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 7/30/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200161960MEDICAIDINDIANA
2=========001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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