Individual
ROBERT JOSEPH GOULET JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7120 CLEARVISTA DR STE 3200, INDIANAPOLIS, IN 46256-1782
(317) 621-7780
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01035324A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000687809
ANTHEM PIN
IN
01
—
000000780843
ANTHEM
IN
05
—
100354730
—
IN
01
—
P01218740
RR MEDIARE PTAN
IN
Enumeration date
04/27/2006
Last updated
09/02/2022
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