Healthcare Provider Details

I. General information

NPI: 1417956442
Provider Name (Legal Business Name): PATRICIA W THARP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W DIVISION ST
EVANSVILLE IN
47710-1374
US

IV. Provider business mailing address

315 MULBERRY ST
EVANSVILLE IN
47713-1252
US

V. Phone/Fax

Practice location:
  • Phone: 812-436-4501
  • Fax: 812-436-4510
Mailing address:
  • Phone: 812-421-7489
  • Fax: 812-421-7497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01039686A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: