Provider Demographics
NPI:1811932528
Name:ROBERT F LEBOW LLC
Entity type:Organization
Organization Name:ROBERT F LEBOW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:LEBOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:317-262-0950
Mailing Address - Street 1:907 E MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-3625
Mailing Address - Country:US
Mailing Address - Phone:317-262-0950
Mailing Address - Fax:317-267-0244
Practice Address - Street 1:907 E MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-3625
Practice Address - Country:US
Practice Address - Phone:317-262-0950
Practice Address - Fax:317-267-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200314500AMedicaid
IN200314500AMedicaid