Provider Demographics
NPI:1902921950
Name:FURY, ROBERT JOHN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:FURY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 CUMBERLAND RD
Mailing Address - Street 2:#100
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7005
Mailing Address - Country:US
Mailing Address - Phone:317-578-7700
Mailing Address - Fax:317-577-9355
Practice Address - Street 1:11501 CUMBERLAND RD
Practice Address - Street 2:#100
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7005
Practice Address - Country:US
Practice Address - Phone:317-578-7700
Practice Address - Fax:317-577-9355
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001809A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200205860Medicaid
IN000000093147OtherBCBS
IN000000093147OtherUNICARE
IN000000093147OtherUNICARE
IN200205860Medicaid