Healthcare Provider Details

I. General information

NPI: 1609717784
Provider Name (Legal Business Name): FFR HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 PROFESSIONAL CT
LAFAYETTE IN
47905-5152
US

IV. Provider business mailing address

40 PROFESSIONAL CT
LAFAYETTE IN
47905-5152
US

V. Phone/Fax

Practice location:
  • Phone: 765-756-5077
  • Fax: 800-810-3955
Mailing address:
  • Phone: 765-756-5077
  • Fax: 800-810-3955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUSAN HAMELMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 765-756-5077