Provider Demographics
NPI:1225238603
Name:FEENEY, TAMZON DONNA (DO)
Entity Type:Individual
Prefix:DR
First Name:TAMZON
Middle Name:DONNA
Last Name:FEENEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-1712
Mailing Address - Country:US
Mailing Address - Phone:719-216-4462
Mailing Address - Fax:
Practice Address - Street 1:2204 W 58TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46228-1712
Practice Address - Country:US
Practice Address - Phone:719-216-4462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000728A204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN02000728OtherOSTEOPATHIC PHYSICIAN LICENSE
IN02000728OtherOSTEOPATHIC PHYSICIAN LICENSE
INAR9685302OtherDEA