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Individual

DR. THOMAS H FAIRCHILD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5255 EAST STOP 11 ROAD, SUITE 400, INDIANAPOLIS, IN 46237-6341
(317) 573-4370
(317) 819-0044
Mailing address
9002 NORTH MERIDIAN STREET, SUITE 222, INDIANAPOLIS, IN 46260-5350
(317) 573-4370
(317) 819-0044

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01029453A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040008969
MEDICARE RAILROAD
IN
05
100338660
IN
Enumeration date
01/03/2007
Last updated
12/27/2013
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