Provider Demographics
NPI:1831136878
Name:ALLEY, THOMAS WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:ALLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8780 PURDUE RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6129
Mailing Address - Country:US
Mailing Address - Phone:317-471-8701
Mailing Address - Fax:317-471-8702
Practice Address - Street 1:8780 PURDUE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-6129
Practice Address - Country:US
Practice Address - Phone:317-471-8701
Practice Address - Fax:317-471-8702
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01020069A207QG0300X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01020069BOtherCSR
IN01020069AOtherINDIANA LICENSE
IN01020069AOtherINDIANA LICENSE
IN01020069AOtherINDIANA LICENSE