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Olivia Grayce Tack, MD
Pediatrics Physician in South Bend, Indiana
NPI 1255371514

Olivia Grayce Tack is a Pediatrics Physician based in South Bend, IN. Olivia Grayce Tack practices in South Bend, IN and has the professional credentials of MD. The NPI Number for Olivia Grayce Tack is 1255371514 and holds a License No. 01062281A (Indiana).

The current practice location address for Olivia Grayce Tack is 2235 Cleveland Rd, South Bend, IN and can be reached out via phone at 574-647-4530 and via fax at 574-647-2285.

Location: 2235 Cleveland Rd, South Bend, IN, 46617-1924
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255371514
Provider Name
Olivia Grayce Tack
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
2235 Cleveland Rd, South Bend, IN, 46617-1924
Phone Number
574-647-4530
Fax Number
574-647-2285
Provider Enumeration Date
06/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
247000031 01 IN MEDICARE PTAN
200828650 05 IN
institution
Provider Business Practice Location Address Details
Address
2235 Cleveland Rd
City
South Bend
State
Indiana
Zip
46628-3529
Phone Number
574-647-4530
Fax Number
574-647-2285
person
Provider Business Mailing Address Details
Address
2235 Cleveland Rd
City
South Bend
State
Indiana
Zip
46628-3529
Phone Number
574-647-4530
Fax Number
574-647-2285
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
-
Taxonomy
208000000X
License No.
01062281A (Indiana)
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
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