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Southlake Internal Medicine Llc
Specialist in Crown Point, Indiana
NPI 1568995785

Southlake Internal Medicine Llc is a Specialist based in Crown Point, IN. Southlake Internal Medicine Llc practices in Crown Point, IN. The NPI Number for Southlake Internal Medicine Llc is 1568995785 and holds a License No. 01066300 (Indiana).

The current practice location address for Southlake Internal Medicine Llc is 928 Mary Ellen Dr, Crown Point, IN and can be reached out via phone at 219-252-0309.

Location: 928 Mary Ellen Dr, Crown Point, IN, 46307-8998
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568995785
Provider Name
Southlake Internal Medicine Llc
Credential
Provider Entity Type
Organization
Address
928 Mary Ellen Dr, Crown Point, IN, 46307-8998
Phone Number
219-252-0309
Fax Number
Provider Enumeration Date
04/05/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
928 Mary Ellen Dr
City
Crown Point
State
Indiana
Zip
46307-8998
Phone Number
219-252-0309
Fax Number
person
Provider Business Mailing Address Details
Address
928 Mary Ellen Dr
City
Crown Point
State
Indiana
Zip
46307-8998
Phone Number
219-252-0309
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
01066300 (Indiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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