Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 01033135A | IN |
N | 207RG0100X | Gastroenterologist | 31257 | NC |
NPI | 1033167796 |
---|---|
Provider Name | Dr. Thomas A Carr |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-2803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 23/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201127190 | (05) | IN |
C83149 | (02) | NC |
P01238612 | RAILROAD MEDICARE (01) | IN |