Healthcare Provider Details

I. General information

NPI: 1487611034
Provider Name (Legal Business Name): ALYSIA TURNER TOWNSEND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MACARTHUR BLVD
MUNSTER IN
46321
US

IV. Provider business mailing address

901 MACARTHUR BLVD
MUNSTER IN
46321-2901
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-1600
  • Fax:
Mailing address:
  • Phone: 219-836-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036110641
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01067283A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: