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NPI Code Detail

MEDICARE: COREY TOM DO

MEDICARE: COREY TOM 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
1207Q00000XFamily Medicine Physician02008585AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
102008585AOTHERINLICENSE

General Provider Information

NPI Number : 1629772181
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY TOM DO
Provider Business Mailing Address
First Line : 30 W RAMPART ST STE 200
Second Line :
City : SHELBYVILLE
State : IN
Zip : 46176-8846
Country : US
Telephone Number : 317-421-2012
Fax Number : 317-398-1851
Provider Business Practice Location Address
First Line : 2451 INTELLIPLEX DR
Second Line : STE 260
City : SHELBYVILLE
State : IN
Zip : 46176-8580
Country : US
Telephone Number : 317-398-0121
Fax Number : 317-398-0538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 06/04/2026

Similar Medicare Providers

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1679576789 — CHRIS L LOMAN M.D.
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1093795528 — DR. THOMAS HARRY WEBB III M.D.
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Practice Fax:
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1295772705 — NANCY R MILES MD
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Directions to “ COREY TOM DO” Practice Location

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