| Dr Lisa M Malone, MD | |
|
6050 Sterling Creek Rd, Portage, IN 46368-7752 | |
| (219) 763-8112 | |
| (219) 764-5380 |
| Full Name | Dr Lisa M Malone |
|---|---|
| Gender | Female |
| Speciality | Obstetrics & Gynecology |
| Location | 6050 Sterling Creek Rd, Portage, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588647523 | NPI | - | NPPES |
| 036091949 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 036091949 (Illinois) | Primary |
| Entity Name | Vna Health Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508826983 PECOS PAC ID: 6901879311 Enrollment ID: O20041004000258 |
| Entity Name | Obhg Illinois Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700107216 PECOS PAC ID: 7810179702 Enrollment ID: O20110314001065 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lisa M Malone, MD Po Box 1430, Portage, IN 46368-9230 Ph: (219) 763-8112 | Dr Lisa M Malone, MD 6050 Sterling Creek Rd, Portage, IN 46368-7752 Ph: (219) 763-8112 |
Dana Dawnielle Jones, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 6050 Sterling Creek Rd, Portage, IN 46368 Phone: 219-763-8112 | |
Travis Haldeman, D.O. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3545 Arbor Blvd, Portage, IN 46368 Phone: 708-636-9205 Fax: 708-229-6075 | |
Miljan R Stankovic, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 3564 Scottsdale St, Portage, IN 46368 Phone: 219-763-8112 Fax: 219-764-3251 | |
Megan E App, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: Po Box 1430, Portage, IN 46368 Phone: 219-764-5356 |