Provider Demographics
NPI:1487620779
Name:DEATON, ROBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:DEATON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11711 BRADFORD PL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3393
Mailing Address - Country:US
Mailing Address - Phone:317-848-6990
Mailing Address - Fax:317-575-7333
Practice Address - Street 1:8111 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2479
Practice Address - Country:US
Practice Address - Phone:317-575-7300
Practice Address - Fax:317-575-7333
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2018-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01025331A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100382000Medicaid
IN100382000Medicaid
IN160020866Medicare PIN
IN677690JJMedicare PIN