Wisely, Lori M
Wisely, Lori M is an individual health care provider with primary practice located at 1060 S Main St; Suite 4, Tipton IN 46072-8327. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wisely, Lori M can be contacted via phone (765) 675-2069.Contact Information
Primary practice address
1060 S Main St; Suite 4
Tipton IN 46072-8327
Phone: (765) 675-2069
Fax: (765) 675-7327
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01042996A | Indiana |
Profile Details
| NPI number | 1508856832 |
|---|---|
| LBN Legal business name | Wisely, Lori M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Nov 25th, 2020 - 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 | 1508856832 | NPPES |
| Indiana | MEDICAID | 200106590A | |
| Indiana | MEDICAID | 200106590 |
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