MEDICARE: LEE ANN PIXLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	01060490A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18566	OTHER	IN	PHYSICIANS HEALTH PLAN
2	4417545	OTHER	IN	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5518261	OTHER	IN	CIGNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	45-0513187	OTHER	IN	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1013999341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE ANN PIXLEY MD

Provider Business Mailing Address
First Line	:	11109 PARKVIEW PLAZA DR # 117
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1314 E 7TH ST STE 101
Second Line	:
City	:	AUBURN
State	:	IN
Zip	:	46706-2533
Country	:	US
Telephone Number	:	260-925-3500
Fax Number	:	260-925-3195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	06/04/2024

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Directions to “ LEE ANN PIXLEY MD” Practice Location

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