Individual
THOMAS M. REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
821 N DIXON RD, KOKOMO, IN 46901-1754
(765) 450-0111
(765) 553-5504
Mailing address
13225 N MERIDIAN ST, CARMEL, IN 46032-5480
(317) 228-7000
(317) 228-2321
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
01047334A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020552
M-PLAN PROVIDER NUMBER
IN
01
—
000000224240
UNICARE PROVIDER NUMBER
IN
05
—
200186170
—
IN
01
—
366735000
US DEPT. OF LABOR
IN
01
—
5174577
AETNA PROVIDER NUMBER
IN
01
—
P00108315
MEDICARE RAILROAD
IN
Enumeration date
09/13/2006
Last updated
05/31/2016
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