Provider Demographics
NPI:1265490015
Name:VOGEL, THOMAS A (DPM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:VOGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9865 E 116TH ST
Mailing Address - Street 2:STE 300
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9237
Mailing Address - Country:US
Mailing Address - Phone:317-284-8888
Mailing Address - Fax:317-284-8891
Practice Address - Street 1:9865 E 116TH ST
Practice Address - Street 2:STE 300
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9237
Practice Address - Country:US
Practice Address - Phone:317-284-8888
Practice Address - Fax:317-284-8891
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000619A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100096450CMedicaid
IN000000382914OtherANTHEM BLUE CROSS BLUE SH
IN100096450CMedicaid
IN5783320001Medicare NSC
INT81877Medicare UPIN