Dr. Kennard B Sproul, M.D.
Family Medicine, Adult Medicine in Indianapolis, IN. Individual provider (NPI-1).
NPI number1043590102
StatusActive
Last updated in NPPESAug 22, 2011
Details
- NPI
- 1043590102
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kennard B Sproul
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 22, 2011
- Last updated
- Aug 22, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0505X | Family Medicine, Adult Medicine | 01029027A | IN | Yes |
Practice location
1481 W 10th StVa Medical Center
Indianapolis, IN 46202-2803
Phone 317-554-0000
Mailing address
7805 N Crestwood LnBrazil, IN 47834-8279
Phone 812-841-9184
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