Basic Information
| Provider Information | |||||||||
| NPI: | 1134243884 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TUNNELL | ||||||||
| FirstName: | LARRY | ||||||||
| MiddleName: | ONEIL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5940 DECATUR BLVD | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462419579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178562945 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5940 DECATUR BLVD | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462419579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178562945 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 01/24/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01041993A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.