Healthcare Provider Details

I. General information

NPI: 1770189680
Provider Name (Legal Business Name): QUOC DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 OLIO RD
FISHERS IN
46037-7618
US

IV. Provider business mailing address

11700 OLIO RD
FISHERS IN
46037-7618
US

V. Phone/Fax

Practice location:
  • Phone: 317-598-8515
  • Fax:
Mailing address:
  • Phone: 317-598-8515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26029081A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: