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NPI Code Detail

MEDICARE: FX SERVICES OF LAFAYETTE, INC.

MEDICARE: FX SERVICES OF LAFAYETTE, 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
1208100000XPhysical Medicine & Rehabilitation Physician01072157AIN

General Provider Information

NPI Number : 1477991453
Entity Type Code : Organization
Provider Name (Legal Business Name) : FX SERVICES OF LAFAYETTE, INC.
Provider Business Mailing Address
First Line : 950 PARK EAST BLVD
Second Line :
City : LAFAYETTE
State : IN
Zip : 47905-0792
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 950 PARK EAST BLVD
Second Line :
City : LAFAYETTE
State : IN
Zip : 47905-0792
Country : US
Telephone Number : 800-294-7001
Fax Number :
Authorized Official
Title or Position : MD/OWNER
Name : FAX XI
Credential : MD
Telephone Number : 717-875-8909
Provider Enumeration Date : 06/12/2013
Last Update Date : 06/12/2013

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Directions to “FX SERVICES OF LAFAYETTE, INC. ” Practice Location

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