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General NPI Number Information
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NPI Number | 1154317907
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Entity Type | Individual
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Provider Name | TIMOTHY R TANSELLE MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 1500 DARLINGTON AVE STE 300
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-2057
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Country | US
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Telephone | 765-362-4940
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Fax | 765-362-1302
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Provider Business Mailing Address
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Address Line | 1040 SIERRA DRIVE SUITE 400
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City | GREENWOOD
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State | IN
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Zip | 46143-7241
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Country | US
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Telephone | 317-528-4284
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Fax | 317-865-8355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01028702
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01028702A
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License Number State | IN
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