Wykoff, Lori A

Wykoff, Lori A is an individual health care provider with primary practice located at 415 E Madison St , South Bend IN 46617. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Wykoff, Lori A can be contacted via phone (574) 533-1234.

Contact Information

Primary practice address
415 E Madison St South Bend IN 46617
Phone: (574) 533-1234
Fax: (574) 537-2652
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01043680A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01043680A Indiana

Profile Details

NPI number 1104816784
LBN Legal business name Wykoff, Lori A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Apr 1st, 2019 - about 5 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 1104816784 NPPES
Indiana MEDICAID 200078780

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