Individual
BRENT TAYLOR BACUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1701 N SENATE BLVD # AG012, INDIANAPOLIS, IN 46202-1239
(317) 962-5975
Mailing address
1701 N SENATE BLVD # AG012, INDIANAPOLIS, IN 46202-1239
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01090460A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/07/2020
Last updated
08/08/2023
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