Healthcare Provider Details

I. General information

NPI: 1578758975
Provider Name (Legal Business Name): TONYA J HOLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2007
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W 86TH ST ST VINCENT HOSPITAL
INDIANAPOLIS IN
46260-1902
US

IV. Provider business mailing address

2001 W 86TH ST ST VINCENT HOSPITAL
INDIANAPOLIS IN
46260-1902
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-2121
  • Fax:
Mailing address:
  • Phone: 317-338-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number01062246A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01062246A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: