| Clarence H Thomas Md Llc | |
|
6021 Kentucky Avenue Indianapolis IN 46221 | |
| (317) 856-5565 | |
| (317) 856-1202 |
| Full Name | Clarence H Thomas Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6021 Kentucky Avenue, Indianapolis, Indiana |
| Authorized Official Name and Position | Clarence Henry Thomas (OWNER) |
| Authorized Official Contact | 3178565565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarence H Thomas Md Llc 6021 Kentucky Ave Indianapolis IN 46221-9701 Ph: (317) 856-5565 | Clarence H Thomas Md Llc 6021 Kentucky Avenue Indianapolis IN 46221 Ph: (317) 856-5565 |
| NPI Number | 1619074812 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 03/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619074812 | NPI | - | NPPES |
| 200365090 | Medicaid | IN | |
| 000000384605 | Other | IN | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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