Provider Demographics
NPI:1437140449
Name:WISLER, THOMAS CHARLES JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHARLES
Last Name:WISLER
Suffix:JR
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 1:8360 S EMERSON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8745
Mailing Address - Country:US
Mailing Address - Phone:317-859-2535
Mailing Address - Fax:317-859-2540
Practice Address - Street 1:8360 S EMERSON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8745
Practice Address - Country:US
Practice Address - Phone:317-859-2535
Practice Address - Fax:317-859-2540
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061511A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200815610Medicaid
IN677690LMedicare PIN
IN200815610Medicaid