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Individual

ROBERT L FAWCETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
401 JOHN ST, EVANSVILLE, IN 47713-2733
(812) 436-0224
(812) 436-0230
Mailing address
315 MULBERRY ST, EVANSVILLE, IN 47713-1252
(812) 421-7489
(812) 436-0209

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
23450
KY
207Q00000X
Family Medicine Physician
Primary
01030700A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200065860
IN
05
64234503
KY
Enumeration date
10/19/2005
Last updated
04/27/2021
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