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NPI Code Detail

MEDICARE: LIFESPRING, INC

MEDICARE: LIFESPRING, INC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1124868740
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFESPRING, INC
Provider Business Mailing Address
First Line : 460 SPRING ST
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-3452
Country : US
Telephone Number : 812-280-2080
Fax Number :
Provider Business Practice Location Address
First Line : 260 S MAPLE ST
Second Line :
City : ORLEANS
State : IN
Zip : 47452-1724
Country : US
Telephone Number : 812-865-3350
Fax Number : 812-206-1243
Authorized Official
Title or Position : PRACTICE MANAGEMENT ADMINISTRATOR
Name : KRISTIE SWOBODA
Credential :
Telephone Number : 812-206-1249
Provider Enumeration Date : 05/30/2024
Last Update Date : 05/30/2024

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Directions to “LIFESPRING, INC ” Practice Location

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