Healthcare Provider Details

I. General information

NPI: 1669418935
Provider Name (Legal Business Name): SHEILA B. THOMAS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEILA BENITIA TRIPLETT D.O.

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9820 WESTPOINT DR STE 500
INDIANAPOLIS IN
46256-3362
US

IV. Provider business mailing address

9820 WESTPOINT DR STE 500
INDIANAPOLIS IN
46256-3362
US

V. Phone/Fax

Practice location:
  • Phone: 317-253-7795
  • Fax: 317-253-7798
Mailing address:
  • Phone: 317-253-7795
  • Fax: 317-253-7798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1591
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3996
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02003529A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: