Healthcare Provider Details

I. General information

NPI: 1437732625
Provider Name (Legal Business Name): ROD JAMES NAULT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MACARTHUR BLVD ANESTHESIA DEPARTMENT
MUNSTER IN
46321-2901
US

IV. Provider business mailing address

901 MACARTHUR BLVD ANESTHESIA DEPARTMENT
MUNSTER IN
46321-2901
US

V. Phone/Fax

Practice location:
  • Phone: 219-703-1443
  • Fax: 219-513-1127
Mailing address:
  • Phone: 219-703-1443
  • Fax: 219-513-1127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01100784A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: