Healthcare Provider Details

I. General information

NPI: 1346282241
Provider Name (Legal Business Name): ROBERT E ALLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 S STOCKWELL RD
EVANSVILLE IN
47714-0247
US

IV. Provider business mailing address

415 MULBERRY ST
EVANSVILLE IN
47713-1230
US

V. Phone/Fax

Practice location:
  • Phone: 812-476-5437
  • Fax: 812-422-7558
Mailing address:
  • Phone: 812-423-7791
  • Fax: 812-422-7558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number01055924A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01055924A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number01055924A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: