Individual
DR. THOMAS ALLAN DECILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 N BUCKEYE ST, OSGOOD, IN 47037-1134
(812) 689-3424
(812) 689-0174
Mailing address
112 N BUCKEYE ST, OSGOOD, IN 47037-1134
(812) 689-3424
(812) 689-0174
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01039988
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200051440
—
IN
Enumeration date
01/23/2007
Last updated
08/12/2010
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