Healthcare Provider Details

I. General information

NPI: 1003619891
Provider Name (Legal Business Name): ADAM D KANZLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12065 OLD MERIDIAN ST STE 205
CARMEL IN
46032-8777
US

IV. Provider business mailing address

10201 N ILLINOIS ST STE 110
CARMEL IN
46290-1172
US

V. Phone/Fax

Practice location:
  • Phone: 317-844-7059
  • Fax: 317-819-4525
Mailing address:
  • Phone: 317-844-7059
  • Fax: 317-819-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number17001548A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: