Provider Demographics
NPI:1508901034
Name:OLDRICH J KOLAR, MD PC
Entity Type:Organization
Organization Name:OLDRICH J KOLAR, MD PC
Other - Org Name:INDIANA CENTER FOR MS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OLDRICH
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOLAR
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:317-614-3100
Mailing Address - Street 1:8424 NAAB RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5918
Mailing Address - Country:US
Mailing Address - Phone:317-614-3100
Mailing Address - Fax:317-614-3111
Practice Address - Street 1:8424 NAAB RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5918
Practice Address - Country:US
Practice Address - Phone:317-614-3100
Practice Address - Fax:317-614-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN189950Medicare ID - Type UnspecifiedMEDICARE GROUP ID