Provider Demographics
NPI:1376598706
Name:SALVAT, RICARDO RAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:RAUL
Last Name:SALVAT
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:202 SE 1ST ST
Mailing Address - Street 2:APT 302
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1087
Mailing Address - Country:US
Mailing Address - Phone:812-433-5122
Mailing Address - Fax:812-465-6287
Practice Address - Street 1:500 E WALNUT ST
Practice Address - Street 2:EVANSVILLE OUTPATIENT CLINIC
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-2438
Practice Address - Country:US
Practice Address - Phone:812-465-6247
Practice Address - Fax:812-465-6287
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN18003382A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist