Provider Demographics
NPI:1932214798
Name:RIFE, LAURA LEE (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:RIFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-1236
Mailing Address - Country:US
Mailing Address - Phone:317-392-3211
Mailing Address - Fax:317-398-1852
Practice Address - Street 1:1626 E STATE ROAD 44
Practice Address - Street 2:SUITE B
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-4026
Practice Address - Country:US
Practice Address - Phone:317-421-2012
Practice Address - Fax:317-398-1852
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01053144A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01053144Medicaid
IN01053144BOtherCSR
IN01053144BOtherCSR
IN941020H3Medicare PIN
INH27899Medicare UPIN