Southern, Thomas E
Southern, Thomas E is an sole proprietor health care provider with primary practice located at 3520 Guion Rd Ste 301, Indianapolis IN 46222-1672. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck, Allopathic & Osteopathic Physicians / Surgery of the Hand, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is his primary health care specialty. Southern, Thomas E can be contacted via phone (317) 926-1356.Contact Information
Primary practice address
3520 Guion Rd Ste 301
Indianapolis IN 46222-1672
Phone: (317) 926-1356
Fax: (317) 926-1465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 01023497A | Indiana |
| Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck | 2082S0099X | 01023497A | Indiana |
| Allopathic & Osteopathic Physicians / Surgery of the Hand | 2082S0105X | 01023497A | Indiana |
| Allopathic & Osteopathic Physicians / Surgery of the Hand | 2086S0105X | 01023497A | Indiana |
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 01023497A | Indiana |
Profile Details
| NPI number | 1104996370 |
|---|---|
| LBN Legal business name | Southern, Thomas E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 8th, 2006 |
| Last updated | Mar 19th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104996370 | NPPES |
| Indiana | Other | 000000762785 | BCBS |
| Indiana | MEDICAID | 100073340A | BCBS |
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