Provider Demographics
NPI:1457340622
Name:PAFFORD, CARL M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:M
Last Name:PAFFORD
Suffix:
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 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8890 E 116TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2820
Practice Address - Country:US
Practice Address - Phone:317-621-1500
Practice Address - Fax:317-621-1509
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052893A207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000850979OtherANTHEM PIN
IN000000603506OtherANTHEM - TIPTON HOSPITAL
INP01679333OtherRR MEDICARE
IN200297780Medicaid
IN000000572613OtherANTHEM
IN266180060Medicare PIN
IN000000850979OtherANTHEM PIN
IN264430169Medicare PIN
IN256870DMedicare PIN