| Laporte Osteopathic Family Practice | |
|
125 East Shore Parkway Suite D La Porte IN 46350-5677 | |
| (219) 325-0155 | |
| Not Available |
| Full Name | Laporte Osteopathic Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 125 East Shore Parkway, La Porte, Indiana |
| Authorized Official Name and Position | Clayton Bert Alexander (PRESIDENT/ DOCTOR) |
| Authorized Official Contact | 2193250155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laporte Osteopathic Family Practice 125 East Shore Parkway Suite D La Porte IN 46350-5672 Ph: (219) 325-0155 | Laporte Osteopathic Family Practice 125 East Shore Parkway Suite D La Porte IN 46350-5677 Ph: (219) 325-0155 |
| NPI Number | 1568656320 |
|---|---|
| Provider Enumeration Date | 09/04/2007 |
| Last Update Date | 12/08/2020 |
| Medicare PECOS PAC ID | 7113195371 |
|---|---|
| Medicare Enrollment ID | O20110714000562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568656320 | NPI | - | NPPES |
| 100164980 | Medicaid | IN | |
| 000000084179 | Other | IN | ANTHEM BLUE CROSS |
| 15D0355679 | Other | IN | CLIA |
| 080025306 | Other | IN | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Clayton Bert Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992794879 PECOS PAC ID: 7214106780 Enrollment ID: I20110818000177 |
La Porte Regional Physician Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Lincolnway, Suite 206, La Porte, IN 46350 Phone: 219-324-3053 Fax: 219-324-5352 | |
Indiana University Health La Porte Hospital Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Teegarden St, La Porte, IN 46350 Phone: 219-326-0043 | |
Charles F Motley Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6916 W Johnson Rd, La Porte, IN 46350 Phone: 219-872-7247 Fax: 219-879-8609 | |
Healthlinc, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 Teegarden St, La Porte, IN 46350 Phone: 888-580-1060 Fax: 219-465-9507 | |
Healthlinc, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1509 State St Ste B, La Porte, IN 46350 Phone: 219-413-5100 Fax: 219-465-9507 | |
Laporte Regional Physician Netork Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7002 W Johnson Rd, La Porte, IN 46350 Phone: 219-325-0604 Fax: 219-879-1401 |