Healthcare Provider Details

I. General information

NPI: 1740387109
Provider Name (Legal Business Name): ALICYN D ROBB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6527 CARROLLTON AVE
INDIANAPOLIS IN
46220-1664
US

IV. Provider business mailing address

6527 CARROLLTON AVE
INDIANAPOLIS IN
46220-1664
US

V. Phone/Fax

Practice location:
  • Phone: 317-875-0009
  • Fax: 317-875-3993
Mailing address:
  • Phone: 317-875-0009
  • Fax: 317-875-3993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01054869A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: