Individual
SHANNON M TIGHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8150 OAKLANDON ROAD, SUITE 130, INDIANAPOLIS, IN 46236-9554
(317) 621-7111
(317) 621-7110
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-0868
(317) 621-1110
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01061627A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000624364
ANTHEM
IN
05
—
200831060
—
IN
01
—
7898849
AETNA
IN
Enumeration date
06/10/2006
Last updated
11/27/2023
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