Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jefferson Lake Emergency Physicians LLC

Organization Emergency Medicine Physician · NPI 1649608795

Jefferson Lake Emergency Physicians LLC is an Emergency Medicine Physician in Madison, Indiana. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1373 E State Road 62
Madison, IN 47250-7328
Phone: (812) 801-0800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1649608795
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karen Vaughn — Officer · (973) 251-1132
NPI enumeratedOctober 29, 2013
Last updated in NPPESMarch 30, 2023
Certification dateMarch 30, 2023
Mailing addressPo Box 37979, Philadelphia, PA 19101-0579

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