Basic Information
| Provider Information | |||||||||
| NPI: | 1780128454 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITY HEALTHCARE, LLC | ||||||||
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| OtherOrganizationName: | LAFAYETTE ORTHOPEDIC CLINIC FRANKFORT | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4699 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 479034699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654492732 | ||||||||
| FaxNumber: | 7654491196 | ||||||||
| Practice Location | |||||||||
| Address1: | 1258 OAK ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | FRANKFORT | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460413377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654270195 | ||||||||
| FaxNumber: | 7654474168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2016 | ||||||||
| LastUpdateDate: | 12/14/2016 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | MARTHA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIR OF BILLING | ||||||||
| AuthorizedOfficialTelephone: | 7654465417 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | IN | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.