Provider Demographics
NPI:1144325226
Name:TANDY, JAMES BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRUCE
Last Name:TANDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6930 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4262
Mailing Address - Country:US
Mailing Address - Phone:317-841-8600
Mailing Address - Fax:317-842-8349
Practice Address - Street 1:6930 E 71ST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4262
Practice Address - Country:US
Practice Address - Phone:317-841-8600
Practice Address - Fax:317-842-8349
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10130277A2084P0800X
IN01030277A2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC25735Medicare UPIN
IN823520Medicare ID - Type Unspecified