Provider Demographics
NPI:1972042208
Name:MATHES, ROBERT (HEARING INSTUMENT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MATHES
Suffix:
Gender:M
Credentials:HEARING INSTUMENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 BRILL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46225-2441
Mailing Address - Country:US
Mailing Address - Phone:317-492-3142
Mailing Address - Fax:
Practice Address - Street 1:1299 W 86TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2203
Practice Address - Country:US
Practice Address - Phone:317-872-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001441A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist