MEDICARE: MR. ROBERT ALLEN STRAIGHT PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	IA 518	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851381453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT ALLEN STRAIGHT PH.D.

Provider Business Mailing Address
First Line	:	1000 73RD ST.
Second Line	:	STE 5
City	:	DES MOINES
State	:	IA
Zip	:	50311-1321
Country	:	US
Telephone Number	:	515-222-1175
Fax Number	:	515-222-0953

Provider Business Practice Location Address
First Line	:	1000 73RD ST
Second Line	:	STE 5
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50311-1321
Country	:	US
Telephone Number	:	515-222-1175
Fax Number	:	515-222-0953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2007

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