Individual
KILLOL J THAKORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47750-0001
(812) 485-4415
(812) 471-6650
Mailing address
PO BOX 138, EVANSVILLE, IN 47701-0138
(812) 471-1591
(812) 471-6650
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
01045252A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
01045252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200099310
—
IN
Enumeration date
09/14/2005
Last updated
12/13/2016
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