Provider Demographics
NPI:1881784791
Name:EHRHARD, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:EHRHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 S TRUMAN RD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-9768
Mailing Address - Country:US
Mailing Address - Phone:812-634-6700
Mailing Address - Fax:812-634-6712
Practice Address - Street 1:251 S TRUMAN RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-9768
Practice Address - Country:US
Practice Address - Phone:812-634-6700
Practice Address - Fax:812-634-6712
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058606A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00217186OtherRAILROAD MEDICARE
IN200475490AMedicaid
IN841654018OtherTAX ID
IN220820AMedicare PIN
INP00217186OtherRAILROAD MEDICARE