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General NPI Number Information
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NPI Number | 1346414976
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Entity Type | Organization
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Legal Business Name | LAKESHORE BONE & JOINT INSTITUTE, PC
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 2501 CUMBERLAND DR
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City | VALPARAISO
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State | IN
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Zip | 46383-2503
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Country | US
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Telephone | 219-921-1444
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Fax | 219-921-5303
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Provider Business Mailing Address
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Address Line | 601 GATEWAY BLVD N
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City | CHESTERTON
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State | IN
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Zip | 46304-9658
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Country | US
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Telephone | 219-921-1444
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Fax | 219-921-5303
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AARON G ANDERSON
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Credential | MD
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Telephone | 219-921-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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