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General NPI Number Information
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NPI Number | 1306854716
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Entity Type | Individual
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Provider Name | BRUCE METZGAR THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1201 N POST RD STE 4
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4225
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Country | US
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Telephone | 317-405-8833
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Fax | 765-446-9279
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Provider Business Mailing Address
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Address Line | 12466 BENT OAK LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46236-7381
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Country | US
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Telephone | 317-850-3446
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Fax | 831-618-7002
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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 | 01040523
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License Number State | IN
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