Healthcare Provider Details

I. General information

NPI: 1093919086
Provider Name (Legal Business Name): ROBERT A EHRHARD, MDIN, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 W 13TH ST SUITE 325
JASPER IN
47546-1855
US

IV. Provider business mailing address

PO BOX 1028
JASPER IN
47547-1028
US

V. Phone/Fax

Practice location:
  • Phone: 812-634-6700
  • Fax: 812-634-6712
Mailing address:
  • Phone: 812-481-8493
  • Fax: 812-481-8497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01058606A
License Number StateIN

VIII. Authorized Official

Name: DR. ROBERT A EHRHARD
Title or Position: OWNER
Credential: MD
Phone: 812-634-6700