| Doctor Name: | MR. DOUGLAS JOHN LADIKA |
| NPI Number: | 1104076769 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 10000987A |
| Business Practice Address: | 6085 Heartland Dr Suite 205 Zionsville, IN - 460774432 |
| Business Phone Number: | 3177682200 |
| Business Fax Number: | 3177682209 |
| Mailing Address: | 2705 N Lebanon St, Suite 305 LEBANON |
| State: | IN |
| Postal Code: | 460528621 |
| Phone Number: | 7654858677 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2008 |
| NPI Last Update Date: | 02/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 10000987A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |