IndividualActive
Dale Theobald, M.D., PH.D.
NPI 1053383083 · Addiction Psychiatry Physician · Indianapolis, IN
Provider details
- NPI number
- 1053383083
- Entity type
- Individual
- Primary specialty
- Addiction Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D., PH.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 200110234A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7229 Clearvista Dr
Indianapolis, IN 46256-1698
Phone: (317) 621-4341
Fax: (317) 621-4366
Approximate (ZIP-level) locationGet directions
Mailing address
6626 E 75th St
Indianapolis, IN 46250-2805
Registry dates
- Enumerated
- 2006-02-03
- Last updated
- 2023-11-27
- Certified
- 2020-09-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.