Organization
OTOLARYNGOLOGY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS H FAIRCHILD M.D. (PRESIDENT)
(317) 844-7059
Entity
Organization
Contact information
Practice address
1001 HADLEY RD, MOORESVILLE, IN 46158-1794
(317) 844-7059
(317) 573-4352
Mailing address
9002 N MERIDIAN ST, STE 222, INDIANAPOLIS, IN 46260-5350
(317) 573-4370
(317) 819-0044
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100057100E
—
IN
Enumeration date
04/04/2007
Last updated
07/20/2010
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