Healthcare Provider Details

I. General information

NPI: 1437246139
Provider Name (Legal Business Name): JOHN A LAOYE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 KINGSWAY DR STE 400
INDIANAPOLIS IN
46205-1555
US

IV. Provider business mailing address

6950 HILLSDALE CT ATTN: CAROL GORBETT
INDIANAPOLIS IN
46250-2040
US

V. Phone/Fax

Practice location:
  • Phone: 317-472-7903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: