1053318071 NPI number — ROBERT STANLEY FLINT II MD PHD

Table of content: ROBERT STANLEY FLINT II MD PHD (NPI 1053318071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053318071 NPI number — ROBERT STANLEY FLINT II MD PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLINT
Provider First Name:
ROBERT
Provider Middle Name:
STANLEY
Provider Name Prefix Text:
Provider Name Suffix Text:
II
Provider Credential Text:
MD PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053318071
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7321 SHADELAND STATION
Provider Second Line Business Mailing Address:
SUITE 275
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46256
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-863-2095
Provider Business Mailing Address Fax Number:
317-863-2108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 N RITTER AVE
Provider Second Line Business Practice Location Address:
SUITE 451
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-356-8301
Provider Business Practice Location Address Fax Number:
317-351-7249
Provider Enumeration Date:
07/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  01040233A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com