Healthcare Provider Details

I. General information

NPI: 1942231444
Provider Name (Legal Business Name): THURMAN V ALVEY III D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W COUNTY LINE RD
GREENWOOD IN
46142-5195
US

IV. Provider business mailing address

1401 W COUNTY LINE RD
GREENWOOD IN
46142-5195
US

V. Phone/Fax

Practice location:
  • Phone: 317-217-1200
  • Fax: 317-817-1220
Mailing address:
  • Phone: 317-217-1200
  • Fax: 317-817-1220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number02002969A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02002969A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: