Organization
SYCAMORE ANESTHESIA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS M PENDERGAST M.D. (OWNER)
(812) 231-4608
Entity
Organization
Contact information
Practice address
1421 N 7TH ST, TERRE HAUTE, IN 47807-1005
(812) 231-4608
(812) 231-4675
Mailing address
PO BOX 3036, INDIANAPOLIS, IN 46206-3036
(812) 231-4608
(812) 231-4675
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200331190
—
IN
Enumeration date
12/11/2006
Last updated
01/13/2017
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