Individual
THADDAEUS POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8607 E US HIGHWAY 36, AVON, IN 46123-7960
(317) 745-5403
(317) 745-8017
Mailing address
8607 E US HIGHWAY 36, AVON, IN 46123-7960
(317) 745-5403
(317) 745-8017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01032834
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100204190
—
IN
Enumeration date
10/13/2006
Last updated
03/29/2021
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