Individual
DR. JOHN BRADLEY THURSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8330 NAAB RD, SUITE 140, INDIANAPOLIS, IN 46260-5925
(317) 872-6760
(317) 879-4029
Mailing address
8330 NAAB RD, SUITE 140, INDIANAPOLIS, IN 46260-5925
(317) 872-6760
(317) 879-4029
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01024334A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083383
BCBS PIN #
IN
01
—
4248019
AETNA PROVIDER #
IN
Enumeration date
06/21/2006
Last updated
07/23/2007
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