Stark, Eric Wygant

Stark, Eric Wygant is an individual health care provider with primary practice located at 2400 South St , Lafayette IN 47904-3027. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Stark, Eric Wygant can be contacted via phone (765) 448-4319.

Contact Information

Primary practice address
2400 South St Lafayette IN 47904-3027
Phone: (765) 448-4319
Fax: (765) 448-2821
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 01030271A Indiana

Profile Details

NPI number 1750389169
LBN Legal business name Stark, Eric Wygant
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2005
Last updated Jul 16th, 2007 - about 17 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 1750389169 NPPES
Indiana Other 111890E MEDICARE
Indiana Other CA8380 MEDICARE
Indiana Other 176600B MEDICARE
Indiana Other 000000082506 MEDICARE

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