Individual
JEREMIAH LANG THURGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 W 10TH ST, ANESTHESIA DEPT., INDIANAPOLIS, IN 46202-2859
(317) 630-7525
(317) 713-1261
Mailing address
PO BOX 6069, DEPT 110, INDIANAPOLIS, IN 46206-6069
(317) 567-2180
(317) 567-2191
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01065305A
IN
207LP3000X
Pediatric Anesthesiology Physician
Primary
01065305A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000584772
ANTHEM
IN
Enumeration date
06/24/2008
Last updated
11/07/2008
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