Fettig, Lyle P

Fettig, Lyle P is an individual health care provider with primary practice located at 1001 W 10Th St , Indianapolis IN 46202-2859. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Fettig, Lyle P can be contacted via phone (317) 630-7979.

Contact Information

Primary practice address
1001 W 10Th St Indianapolis IN 46202-2859
Phone: (317) 630-7979
Fax: (317) 630-2668
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01059135A Indiana
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 01059135A Indiana

Profile Details

NPI number 1528180494
LBN Legal business name Fettig, Lyle P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2007
Last updated Dec 6th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528180494 NPPES
Indiana MEDICAID 200860060
Indiana Other 000000524792

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