Healthcare Provider Details

I. General information

NPI: 1568565455
Provider Name (Legal Business Name): TYSON V NEUMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5165 MCCARTY LN
LAFAYETTE IN
47905-8764
US

IV. Provider business mailing address

5165 MCCARTY LN
LAFAYETTE IN
47905-8764
US

V. Phone/Fax

Practice location:
  • Phone: 765-838-7211
  • Fax:
Mailing address:
  • Phone: 765-838-7211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01059158A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01059158A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number01059158A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number01059158
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number01059158A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: