Provider Demographics
NPI:1093919086
Name:ROBERT A EHRHARD, MDIN, PC
Entity Type:Organization
Organization Name:ROBERT A EHRHARD, MDIN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:EHRHARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-634-6700
Mailing Address - Street 1:PO BOX 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-481-8493
Mailing Address - Fax:812-481-8497
Practice Address - Street 1:721 W 13TH ST
Practice Address - Street 2:SUITE 325
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-1855
Practice Address - Country:US
Practice Address - Phone:812-634-6700
Practice Address - Fax:812-634-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058606A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200966470Medicaid
INDD2543OtherRAILROAD MEDICARE
IN220820Medicare PIN
IN200966470Medicaid