Individual
ROBERT J LAVIOLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 567-2180
(317) 567-2191
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01026285
IN
207L00000X
Anesthesiology Physician
Primary
01026285A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001566210
ANTHEM PTAN
IN
05
—
100064730
—
IN
01
—
1102189772
ANTHEM PTAN
IN
01
—
Q00229312
RAILROAD PTAN
IN
Enumeration date
07/12/2006
Last updated
12/23/2024
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