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General NPI Number Information
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NPI Number | 1558533935
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Entity Type | Organization
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Legal Business Name | THOMAS C. WISLER, SR., M.D., LLC
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 7830 MCFARLAND LN STE. B
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-4705
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Country | US
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Telephone | 317-889-6551
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Fax | 317-422-8430
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Provider Business Mailing Address
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Address Line | 7830 MCFARLAND LN STE. B
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-4705
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Country | US
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Telephone | 317-889-6551
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Fax | 317-422-8430
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | LINDA K CRITSER
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Credential | CREDENTIALING SPECIA
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Telephone | 317-422-5490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01029384A
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License Number State | IN
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