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General NPI Number Information
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NPI Number | 1144282377
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Entity Type | Individual
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Provider Name | RICHARD CLEAVELIN PROBERT MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 25 W DIVISION ST SUITE 400 WEST
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City | EVANSVILLE
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State | IN
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Zip | 47710-1374
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Country | US
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Telephone | 812-436-4501
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Fax | 812-436-4510
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Provider Business Mailing Address
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Address Line | 315 MULBERRY ST
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City | EVANSVILLE
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State | IN
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Zip | 47713-1252
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Country | US
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Telephone | 812-421-7489
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Fax | 812-436-0209
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01036002
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License Number State | IN
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