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Individual

ROBERT L MCQUADY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1802 E 10TH ST, JEFFERSONVILLE, IN 47130-6016
(812) 288-2488
(770) 573-9513
Mailing address
2100 MARKET ST STE 101, CHARLESTOWN, IN 47111-9535
(812) 503-5100
(770) 573-9513

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
15528
KY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
01079670A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
01079670A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01079670A
STATE LICENSE
IN
05
300010808
IN
01
IN3604023
MEDICARE PTAN
IN
01
K177821
MEDICARE KY
KY
Enumeration date
10/27/2006
Last updated
11/08/2021
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