Healthcare Provider Details

I. General information

NPI: 1881784791
Provider Name (Legal Business Name): ROBERT A EHRHARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 S TRUMAN RD
JASPER IN
47546-9768
US

IV. Provider business mailing address

251 S TRUMAN RD
JASPER IN
47546-9768
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: