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NPI Code Detail

MEDICARE: DR. DAVID B. TARR PH. D., HSPP

MEDICARE: DR. DAVID B. TARR PH. D., HSPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20010518IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000275547OTHERANTHEM PIN NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093746604
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID B. TARR PH. D., HSPP
Provider Business Mailing Address
First Line : 4401 CENTRAL AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1822
Country : US
Telephone Number : 317-923-2333
Fax Number : 317-923-2367
Provider Business Practice Location Address
First Line : 4401 CENTRAL AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1822
Country : US
Telephone Number : 317-923-2333
Fax Number : 317-923-2367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 07/08/2007

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