Provider Demographics
NPI:1376600783
Name:MCSOLEY, THOMAS E (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:MCSOLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9002 N MERIDIAN ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5350
Mailing Address - Country:US
Mailing Address - Phone:317-573-4370
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:11725 N ILLINOIS ST
Practice Address - Street 2:SUITE 445
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3010
Practice Address - Country:US
Practice Address - Phone:317-573-4370
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01028981A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN040000759OtherMEDICARE RAILROAD
IN100237750Medicaid
IN040000759OtherMEDICARE RAILROAD
INB28430Medicare UPIN