Demetris, Cortney Lyne
Demetris, Cortney Lyne is an individual health care provider with primary practice located at 2001 W 86Th St , Indianapolis IN 46260-1902. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Child Abuse Pediatrics, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Child Abuse Pediatrics is her primary health care specialty. Demetris, Cortney Lyne can be contacted via phone (317) 338-6815.Contact Information
Primary practice address
2001 W 86Th St
Indianapolis IN 46260-1902
Phone: (317) 338-6815
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 01060635A | Indiana |
| Allopathic & Osteopathic Physicians / Child Abuse Pediatrics | 2080C0008X | 01060635 | Indiana |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 01060635A | Indiana |
| Allopathic & Osteopathic Physicians / Child Abuse Pediatrics | 2080C0008X | 01060635A | Indiana |
Profile Details
| NPI number | 1821072737 |
|---|---|
| LBN Legal business name | Demetris, Cortney Lyne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Jan 14th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821072737 | NPPES |
| Indiana | MEDICAID | 200518830 |
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