Individual
DR. ALLIE E THOMAS-FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
121 BUNTIN ST, SUITE #1, VINCENNES, IN 47591-1320
(812) 885-2718
(812) 885-2727
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01076813A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201364350
—
IN
Enumeration date
04/05/2012
Last updated
03/20/2024
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