Individual
ROBERT SPAULDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
Mailing address
RCS PROVIDER ENROLLMENT, 1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(317) 963-1093
(317) 222-2126
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01085331A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
KY
Other
Enumeration date
04/03/2017
Last updated
06/02/2021
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