MEDICARE: DR. ANN M LOVKO PHD

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	103TC0700X	Clinical Psychologist	20040533A	IN
2	103TH0100X	Health Service Psychologist	20040533A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000828660	OTHER	IN	ANTHEM BCBS

General Provider Information

NPI Number	:	1306845516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN M LOVKO PHD

Provider Business Mailing Address
First Line	:	6626 E 75TH STREET
Second Line	:	STE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6950 HILLSDALE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2040
Country	:	US
Telephone Number	:	317-621-7740
Fax Number	:	317-621-7608

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	11/27/2023

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