| Laura A Hannon, MD | |
|
8988 E Us Highway 20, New Carlisle, IN 46552-9038 | |
| (574) 654-7779 | |
| (574) 654-7780 |
| Full Name | Laura A Hannon |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 23 Years |
| Location | 8988 E Us Highway 20, New Carlisle, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154339935 | NPI | - | NPPES |
| 00000378303 | Other | IN | ANTHEM, BCBS |
| 200529120A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01061101A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| La Porte Hospital | La porte, IN | Hospital |
| Memorial Hospital Of South Bend | South bend, IN | Hospital |
| Franciscan St Anthony Health - Michigan City | Michigan city, IN | Hospital |
| Miller's Merry Manor | New carlisle, IN | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| La Porte Clinic Company Llc | 0446558357 | 59 |
| Healthlinc Inc | 7618929373 | 72 |
| Entity Name | Healthlinc Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528262581 PECOS PAC ID: 7618929373 Enrollment ID: O20050210000929 |
| Entity Name | La Porte Clinic Company Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568829224 PECOS PAC ID: 0446558357 Enrollment ID: O20160408001751 |
| Mailing Address | Practice Location Address |
|---|---|
| Laura A Hannon, MD 2022 Kelle Dr, Chesterton, IN 46304-8708 Ph: (219) 326-2312 | Laura A Hannon, MD 8988 E Us Highway 20, New Carlisle, IN 46552-9038 Ph: (574) 654-7779 |
Dr. Andrey P Seluzhitskiy, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8984 E Us Highway 20, New Carlisle, IN 46552 Phone: 574-654-8490 Fax: 574-654-3643 |