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Individual

ROBERT WAYNE KIRKPATRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2580 MICHIGAN RD, STE 2, MADISON, IN 47250-2423
(812) 265-6222
(812) 265-2955
Mailing address
2580 MICHIGAN RD, STE 2, MADISON, IN 47250-2423
(812) 265-6222
(812) 265-2955

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001749
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000042676
ANTHEM
IN
01
005398
SIHO
05
100148580
IN
01
351957465050
CARESOURCE
IN
01
410047137
RAILROAD MEDICARE
01
QMXPR0070032
MOLINA
Enumeration date
08/11/2006
Last updated
10/25/2011
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