Fife, Luke Portwood

Fife, Luke Portwood is an individual health care provider with primary practice located at 550 S Landmark Ave , Bloomington IN 47403-3239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Fife, Luke Portwood can be contacted via phone (812) 355-6900.

Contact Information

Primary practice address
550 S Landmark Ave Bloomington IN 47403-3239
Phone: (812) 355-6900
Fax: (812) 355-6912
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 48989 Kentucky
Allopathic & Osteopathic Physicians / Surgery 208600000X 01087459A Indiana

Profile Details

NPI number 1053601682
LBN Legal business name Fife, Luke Portwood
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2011
Last updated Aug 23rd, 2022 - about 2 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 1053601682 NPPES
Kentucky MEDICAID 7100428850

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