Individual
RICHARD BRIAN STALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-8880
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
75000005A
IN
367H00000X
Anesthesiologist Assistant
75000005A
IN
Other
Enumeration date
09/20/2016
Last updated
02/17/2025
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