Provider Demographics
NPI:1609927953
Name:TAULMAN, LARRY SCOTT (DC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:SCOTT
Last Name:TAULMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-5717
Mailing Address - Country:US
Mailing Address - Phone:812-342-9850
Mailing Address - Fax:812-342-9851
Practice Address - Street 1:1001 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5717
Practice Address - Country:US
Practice Address - Phone:812-342-9850
Practice Address - Fax:812-342-9851
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001416A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100194270AMedicaid
IN000000188499OtherANTHEM BLUE CROSS
IN000000188499OtherANTHEM BLUE CROSS