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NPI Code Detail

MEDICARE: DR. PETER GEORGE GARRETT MD

MEDICARE: DR. PETER GEORGE GARRETT MD
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
12085R0001XRadiation Oncology Physician01032997AIN

General Provider Information

NPI Number : 1225031719
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER GEORGE GARRETT MD
Provider Business Mailing Address
First Line : 6100 W 96TH ST
Second Line : SUITE 125
City : INDIANAPOLIS
State : IN
Zip : 46278-6005
Country : US
Telephone Number : 317-715-1800
Fax Number : 317-715-6200
Provider Business Practice Location Address
First Line : 8111 S EMERSON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-8601
Country : US
Telephone Number : 317-865-5171
Fax Number : 317-865-5172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 02/14/2008

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