Provider Demographics
NPI:1699888305
Name:YILMAZ, ALICIA R (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:R
Last Name:YILMAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALICIA
Other - Middle Name:R
Other - Last Name:RISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1351 RONALD REAGAN PKWY STE B
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6764
Practice Address - Country:US
Practice Address - Phone:317-948-3200
Practice Address - Fax:317-217-2424
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061810A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200833770Medicaid
INRES000Medicare UPIN
IN200833770Medicaid
IN152380SSMedicare PIN
IN194590014Medicare PIN