INNOVATIVE MEDICINE NPI 1417486523

NPI Information

NPI: 1417486523
Provider Name: INNOVATIVE MEDICINE
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
3554 PROMENADE PKWY STE H
LAFAYETTE, IN
ZIP 47909
Phone: (765) 471-1100
Get Directions

INNOVATIVE MEDICINE is an addiction medicine family medicine in Lafayette, IN. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. INNOVATIVE MEDICINE NPI is 1417486523. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3554 PROMENADE PKWY STE H
LAFAYETTE, IN
ZIP 47909-418
Phone: (765) 471-1100
Fax: (765) 471-1009

The provider's authorized official is Jacqueline Snyder .
The authorized official title is Billing Manager and has the following contact phone number (765) 413-7100.

The enumeration date for this NPI number is 6/12/2017 and was last updated on 4/18/2024.

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	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	Yes
2	207QA0505X	Family Medicine	Adult Medicine	No
3	207QB0002X	Family Medicine	Obesity Medicine	No
4	332900000X	Non-Pharmacy Dispensing Site		No

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
1	1720219702	OTHER	INDIANA	MELISSA GALBRETH LMHC
2	1144372863	OTHER	INDIANA	ROBERT CHARLES TURNER MD

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: 4/28/2024

NPI Synchronization or Removal

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