Individual
DR. THOMAS A CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1481 W 10TH ST, RICHARD L. ROUDEBUSH VAMC, HSR&D(11H), INDIANAPOLIS, IN 46202-2803
(317) 988-3340
(317) 988-3222
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01033135A
IN
207RG0100X
Gastroenterology Physician
31257
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201127190
—
IN
01
—
P01238612
RAILROAD MEDICARE
IN
Enumeration date
05/05/2006
Last updated
01/23/2014
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