Healthcare Provider Details

I. General information

NPI: 1144359647
Provider Name (Legal Business Name): EUGENE C HSIAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 11/27/2023
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 CLEARVISTA PARKWAY SUITE 210
INDIANAPOLIS IN
46256-4673
US

IV. Provider business mailing address

6626 E 75TH ST 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-2200
  • Fax: 317-621-2204
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number39829
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number2007012288
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number01065313A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: