Individual
THOMAS BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 741-1515
(765) 751-5087
Mailing address
250 N SHADELAND AVE, STE 130, INDIANAPOLIS, IN 46219-4959
(317) 962-4792
(317) 962-4343
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01075582A
IN
207Q00000X
Family Medicine Physician
Primary
01075582A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201239210
—
IN
Enumeration date
06/06/2014
Last updated
08/19/2015
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