Provider Demographics
NPI:1821175092
Name:INZERELLO, ANTHONY THOMAS III (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:THOMAS
Last Name:INZERELLO
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-868-0530
Mailing Address - Fax:812-868-2188
Practice Address - Street 1:1033 E MOUNT PLEASANT RD
Practice Address - Street 2:SUITE D
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-7149
Practice Address - Country:US
Practice Address - Phone:812-868-0530
Practice Address - Fax:812-868-2188
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01052964A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN146080FMedicare ID - Type Unspecified