Provider Demographics
NPI:1275549248
Name:KIZER, CYNTHIA A (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:KIZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E. 75TH STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-1303
Mailing Address - Fax:317-621-1310
Practice Address - Street 1:13121 OLIO RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7240
Practice Address - Country:US
Practice Address - Phone:317-621-1300
Practice Address - Fax:317-621-1310
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058978A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200478400Medicaid
IN000000375863OtherANTHEM
IN000000375863OtherANTHEM
IN200478400Medicaid
IN224310CMedicare PIN