Organization
THOMAS C. WISLER, SR., M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA K CRITSER CREDENTIALING SPECIA (CREDENTIALING SPECIALIST)
(317) 422-5490
Entity
Organization
Contact information
Practice address
7830 MCFARLAND LN, STE. B, INDIANAPOLIS, IN 46237-4705
(317) 889-6551
(317) 422-8430
Mailing address
7830 MCFARLAND LN, STE. B, INDIANAPOLIS, IN 46237-4705
(317) 889-6551
(317) 422-8430
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01029384A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100064260A
—
IN
01
—
1104816271
INDIVIDUAL NPI
IN
01
—
559579
ANTHEM GROUP
IN
01
—
559581
ANTHEM INDIVIDUAL
IN
Enumeration date
03/26/2008
Last updated
06/11/2008
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