Provider Demographics
NPI:1417956442
Name:THARP, PATRICIA W (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:W
Last Name:THARP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:315 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1252
Mailing Address - Country:US
Mailing Address - Phone:812-421-7489
Mailing Address - Fax:812-421-7497
Practice Address - Street 1:25 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1374
Practice Address - Country:US
Practice Address - Phone:812-436-4501
Practice Address - Fax:812-436-4510
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01039686A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000382341OtherANTHEM BCBS
IN01039686AOtherPHYSICIAN LICENSE
IN200079040DOtherMEDICAID GRP
IN100097600Medicaid
IN000000382341OtherANTHEM BCBS