Healthcare Provider Details

I. General information

NPI: 1053318071
Provider Name (Legal Business Name): ROBERT STANLEY FLINT II MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N RITTER AVE SUITE 451
INDIANAPOLIS IN
46219
US

IV. Provider business mailing address

7321 SHADELAND STATION SUITE 275
INDIANAPOLIS IN
46256
US

V. Phone/Fax

Practice location:
  • Phone: 317-356-8301
  • Fax: 317-351-7249
Mailing address:
  • Phone: 317-863-2095
  • Fax: 317-863-2108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01040233A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: