Provider Demographics
NPI:1316043243
Name:TWO INDIANA FOOT, L.L.C.
Entity Type:Organization
Organization Name:TWO INDIANA FOOT, L.L.C.
Other - Org Name:D/B/A: EVANSVILLE FOOT AND ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:HUPFER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:812-475-8900
Mailing Address - Street 1:PO BOX 15454
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-0454
Mailing Address - Country:US
Mailing Address - Phone:812-475-8900
Mailing Address - Fax:812-475-0024
Practice Address - Street 1:2809 LINCOLN AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-1752
Practice Address - Country:US
Practice Address - Phone:812-475-8900
Practice Address - Fax:812-475-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000805A213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDF1524OtherRAILROAD MEDICARE
INU56742Medicare UPIN
IN235420Medicare ID - Type Unspecified
IN5674310001Medicare NSC