THOMAS E SOUTHERN (NPI# 1104996370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104996370 |
| Entity Type | Individual |
| Full Name | THOMAS E SOUTHERN |
| Credential | MD |
| Practice Address |
3520 Guion Rd Ste 301 Indianapolis IN 46222-1672 |
| Mailing Address |
Po Box 637999 Cincinnati OH 45263-7999 |
| Practice Telephone | 3179261356 |
| Practice Fax Number | 3179261465 |
| Mailing Telephone | 3176822030 |
| Mailing Fax Number | 3176445060 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2013-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | 01023497A | IN | Allopathic & Osteopathic Physicians |
| N | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
01023497A | IN | Allopathic & Osteopathic Physicians |
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
01023497A | IN | Allopathic & Osteopathic Physicians |
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
01023497A | IN | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
01023497A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | BCBS | 000000762785 | 01 |
| IN | 100073340A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558981076 | Thomas Laurie Southern Jr. | Speech-Language Pathologist | 53359 Champlain St, Macomb, MI 48042-3739 | 2020-04-24 |
| Street Address |
3520 GUION RD STE 301 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46222-1672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114995610 | Vision of Minority Women, LLC | Home Health | 3520 Guion Rd, Suite 308, Indianapolis, IN 46222-1692 | 2006-03-09 |
| 1588811137 | General and Advanced Laparoscopic Surgery, LLC | Surgery | 3520 Guion Rd, Suite 103, Indianapolis, IN 46222-1692 | 2008-08-26 |
| 1992998819 | James R Hodge | Colon & Rectal Surgery | 3520 Guion Rd, Suite 307, Indianapolis, IN 46222 | 2007-08-23 |
| 1952453409 | Mary Jeanne O'gara | Internal Medicine | 3520 Guion Rd, Ste 100, Indianapolis, IN 46222-1692 | 2007-01-17 |
| 1649362757 | John L George | Surgery | 3520 Guion Rd, Suite 301, Indianapolis, IN 46222-1692 | 2006-09-28 |
| 1609889526 | Indiana General Surgery, P.C. | Surgery | 3520 Guion Rd, Suite 301, Indianapolis, IN 46222-1692 | 2006-08-14 |
| 1598725780 | Mary Burden | Internal Medicine | 3520 Guion Rd, Suite 103, Indianapolis, IN 46222-1692 | 2006-03-23 |
| 1316916562 | Chris A Lowery | Surgery | 3520 Guion Rd, Suite 103, Indianapolis, IN 46222-1692 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871194472 | Megan Mccullough | Pharmacist | 10617 East Washington Street, Pharmacy At Walmart, Indianapolis, IN 46222 | 2020-11-02 |
| 1215401450 | Resilient Services | Counselor | 3519 W Michigan Street, Indianapolis, IN 46222 | 2019-01-21 |
| 1376925487 | Ossama Elbarawy | Dentist | 2410 W. 17th St, Indianapolis, IN 46222 | 2015-06-25 |
| 1780025163 | Suzy Q Service Cororation | Chore Provider | 2401 N Tibbs Ave, Indianapolis, IN 46222 | 2013-07-12 |
| 1952607939 | Monica Lee Mcmullen | Dietitian, Registered | 2732 West Michigan St., Westside Health Center, Indianapolis, IN 46222 | 2011-02-08 |
| 1306082318 | Jose Fanor Melendez | Psychiatry & Neurology | 3422 N. Taft Av, Indianapolis, IN 46222 | 2008-12-22 |
| 1861693277 | David Hazra | Preventive Medicine | 340 S. White River Parkway, Indianapolis, IN 46222 | 2007-05-31 |
| 1528191467 | Rem Indiana | Intermediate Care Facility, Mentally Retarded | 3025 Green Hills Lane, Indianapolis, IN 46222 | 2007-03-13 |
| 1366589467 | Indianapolis Osteopathic Hospital Inc. | Podiatrist | 3520 Guion Rd Suite 204, Indianapolis, IN 46222 | 2007-01-30 |
| 1508919077 | Ronald L. Gemma | Family Medicine | 3750 Guion Rd., Ste. 185, Indianapolis, IN 46222 | 2007-01-19 |
| Find all providers in zip 46222 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982050340 | Eric Pittelkow | Surgery | 545 Barnhill Drive Emerson Hall, Suite 232, Indianapolis, IN 46202 | 2016-05-04 |
| 1164654257 | Erin Weber | Surgery | 1801 N Senate Blvd Ste 525, Indianapolis, IN 46202-1253 | 2009-08-21 |
| 1669677142 | Jaime Marie Ranieri | Surgery | 8051 S Emerson Ave Ste 450, Indianapolis, IN 46237-8667 | 2007-06-15 |
| 1770708158 | Kimberly K Short | Surgery | 8455 Clearvista Place, Indianapolis, IN 46256-2419 | 2007-04-13 |
| 1558344697 | William A Wooden | Surgery | 260 Emerson Hall, 545 Barnhill Dr, Indianapolis, IN 46202-5200 | 2005-11-22 |
| 1881690790 | Jeffrey David Wagner | Surgery | 8040 Clearvista Pkwy, Ste 570, Indianapolis, IN 46256 | 2005-06-24 |
| 1699003400 | Zollman Plastic Surgery | Surgery | 8227 Northwest Blvd, Suite 290, Indianapolis, IN 46278-1387 | 2009-12-07 |
| 1285880997 | Hemant Sabharwal | Surgery | 8051 S Emerson Ave, Suite 480, Indianapolis, IN 46237-8600 | 2008-08-13 |
| 1265697973 | Sidhbh Gallagher | Surgery | 545 Barnhill Dr, Suite 232, Indianapolis, IN 46202-5112 | 2008-07-22 |
| 1982819017 | Indianapolis Institute for Plastic Surgery | Surgery | 8051 S Emerson Ave, Ste 450, Indianapolis, IN 46237-8600 | 2007-05-11 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46222 |
Please comment or provide details below to improve the information on THOMAS E SOUTHERN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.