Individual
DR. STACEY ELAINE TARVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
699 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5119
(317) 274-2172
(317) 278-3031
Mailing address
PO BOX 719094, CHICAGO, IL 60677-9318
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
01064302
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201035650
—
IN
Enumeration date
05/24/2007
Last updated
02/13/2026
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