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1366821449

NPI Code Detail

MEDICARE: ASHLEY TOLBERT M.D.

MEDICARE: ASHLEY TOLBERT M.D.

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	207L00000X	Anesthesiology Physician	125066538	IL
2	207L00000X	Anesthesiology Physician	0108381A	IN
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	0108381A	IN
4	208VP0000X	Pain Medicine Physician	0108381A	IN
5	208VP0014X	Interventional Pain Medicine Physician	0108381A	IN

General Provider Information

NPI Number	:	1366821449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY TOLBERT M.D.

Provider Business Mailing Address
First Line	:	8805 N MERIDIAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2760
Country	:	US
Telephone Number	:	317-706-7246
Fax Number	:	317-708-3417

Provider Business Practice Location Address
First Line	:	8805 N MERIDIAN ST STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2643
Country	:	US
Telephone Number	:	317-706-7246
Fax Number	:

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

Provider Enumeration Date	:	05/22/2015
Last Update Date	:	01/25/2023

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Directions to “ ASHLEY TOLBERT M.D.” Practice Location

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