Provider Demographics
NPI:1184201329
Name:MIDDLETON, ROBERT BRENNON (DPM)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRENNON
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4665 N US HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-8558
Mailing Address - Country:US
Mailing Address - Phone:812-376-9353
Mailing Address - Fax:812-376-3757
Practice Address - Street 1:4665 N US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-8558
Practice Address - Country:US
Practice Address - Phone:812-376-9353
Practice Address - Fax:812-376-3757
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07001459A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist