Healthcare Provider Details

I. General information

NPI: 1497863120
Provider Name (Legal Business Name): THOROUGHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4808 VIKING TRL
NEW CASTLE IN
47362-8810
US

IV. Provider business mailing address

4808 VIKING TRL
NEW CASTLE IN
47362-8810
US

V. Phone/Fax

Practice location:
  • Phone: 765-836-4874
  • Fax: 765-836-5400
Mailing address:
  • Phone: 765-836-4874
  • Fax: 765-836-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01026974
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71001495A
License Number StateIN

VIII. Authorized Official

Name: DR. BRUCE D IPPEL
Title or Position: OWNER
Credential: MD
Phone: 765-836-4874