Healthcare Provider Details

I. General information

NPI: 1427408632
Provider Name (Legal Business Name): THOMAS W LARREW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2016
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DR
INDIANAPOLIS IN
46202-5109
US

IV. Provider business mailing address

705 RILEY HOSPITAL DR STE 1601
INDIANAPOLIS IN
46202-5109
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-6201
  • Fax: 317-948-1482
Mailing address:
  • Phone: 317-948-0227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number01093848A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number35.147658
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: