Provider Demographics
NPI:1205861242
Name:BRIGHT, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 JACKSON ST
Mailing Address - Street 2:#110
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016
Mailing Address - Country:US
Mailing Address - Phone:765-643-6012
Mailing Address - Fax:765-646-9054
Practice Address - Street 1:2101 JACKSON ST
Practice Address - Street 2:#110
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016
Practice Address - Country:US
Practice Address - Phone:765-643-6012
Practice Address - Fax:765-646-9054
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01025073207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
791293142OtherRAILROAD MEDICARE
IN100171760AMedicaid
000000D85468OtherBLUE CROSS BLUE SHIELD
B28720Medicare UPIN
IN100171760AMedicaid