MEDICARE: BRUCE METZGAR THOMAS MD

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
1	207Q00000X	Family Medicine Physician	01040523	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00445265	OTHER	IN	RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000490288	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1306854716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE METZGAR THOMAS MD

Provider Business Mailing Address
First Line	:	12466 BENT OAK LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-7381
Country	:	US
Telephone Number	:	317-850-3446
Fax Number	:	831-618-7002

Provider Business Practice Location Address
First Line	:	1201 N POST RD STE 4
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4225
Country	:	US
Telephone Number	:	317-405-8833
Fax Number	:	765-446-9279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	12/02/2024

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