MEDICARE: HUGH B STARKS 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
1	2084P0800X	Psychiatry Physician	5783	AK
2	2084P0804X	Child & Adolescent Psychiatry Physician	5783	AK
3	2084P0804X	Child & Adolescent Psychiatry Physician	01066052A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548206527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUGH B STARKS MD

Provider Business Mailing Address
First Line	:	P O BOX 269358
Second Line	:
City	:	LAWRENCE
State	:	IN
Zip	:	46226-9358
Country	:	US
Telephone Number	:	317-755-2866
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 HARCOURT ROAD #3031
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-3031
Country	:	US
Telephone Number	:	317-338-2161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	09/19/2012

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Directions to “ HUGH B STARKS MD” Practice Location

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