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NPI Code Detail

MEDICARE: CHARLES WILLIAM TOLAN DO

MEDICARE: CHARLES WILLIAM TOLAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician02002869AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235246158
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES WILLIAM TOLAN DO
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 N MADISON AVE
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-4135
Country : US
Telephone Number : 317-528-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 08/30/2022

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Directions to “ CHARLES WILLIAM TOLAN DO” Practice Location

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