Healthcare Provider Details

I. General information

NPI: 1306854716
Provider Name (Legal Business Name): BRUCE METZGAR THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S LIBERTY DR STE A
BLOOMINGTON IN
47403-5147
US

IV. Provider business mailing address

12466 BENT OAK LN
INDIANAPOLIS IN
46236-7381
US

V. Phone/Fax

Practice location:
  • Phone: 812-727-6700
  • Fax: 812-727-6701
Mailing address:
  • Phone: 317-850-3446
  • Fax: 812-727-6701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number01040523A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: