Healthcare Provider Details

I. General information

NPI: 1144325226
Provider Name (Legal Business Name): JAMES BRUCE TANDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6930 E 71ST ST
INDIANAPOLIS IN
46220-4262
US

IV. Provider business mailing address

6930 E 71ST ST
INDIANAPOLIS IN
46220-4262
US

V. Phone/Fax

Practice location:
  • Phone: 317-841-8600
  • Fax: 317-842-8349
Mailing address:
  • Phone: 317-841-8600
  • Fax: 317-842-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number10130277A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number01030277A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: