Healthcare Provider Details

I. General information

NPI: 1386373173
Provider Name (Legal Business Name): ROBERT LEE FORSTE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6102 HORIZON DR
COLUMBUS IN
47201-1111
US

IV. Provider business mailing address

6102 HORIZON DR
COLUMBUS IN
47201-1111
US

V. Phone/Fax

Practice location:
  • Phone: 812-343-0249
  • Fax:
Mailing address:
  • Phone: 812-343-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number01023874A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: