National Provider Identifier Database

THOMAS E SOUTHERN, MD – NPI #1104996370
Plastic and Reconstructive Surgery

Contact Information

THOMAS E SOUTHERN, MD
3520 GUION RD
STE 301
INDIANAPOLIS, IN  46222-1672
Phone: 317-926-1356
Fax: 317-926-1465
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X
Plastic Surgery 208200000X
Plastic Surgery Within the Head and Neck 2082S0099X
Surgery of the Hand 2082S0105X
Surgery of the Hand 2086S0105X

* Indicates primary specialty

NPI Profile & details for THOMAS E SOUTHERN

NPI Number 1104996370
Credentials MD
Entity Individual
Enumeration date 11/08/2006
Last updated 03/19/2013 - About 13 years ago
Sole proprietor1 Yes
Identifiers
  • IN License #: 01023497A
  • IN Medicaid: 100073340A
  • IN Other: 000000762785 BCBS
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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