Basic Information
| Provider Information | |||||||||
| NPI: | 1770786279 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THOMAS A. WEINZAPFEL, MD, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2522 WATERBRIDGE WAY | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477103200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124226886 | ||||||||
| FaxNumber: | 8124285508 | ||||||||
| Practice Location | |||||||||
| Address1: | 2522 WATERBRIDGE WAY | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477103200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124226886 | ||||||||
| FaxNumber: | 8124285508 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | WEINZAPFEL | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 8124226886 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 000000228811 | 01 | IN | ANTHEM GROUP | OTHER |