Provider Demographics
NPI:1982796066
Name:STELLER, ROB A (OD)
Entity type:Individual
Prefix:
First Name:ROB
Middle Name:A
Last Name:STELLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W 14TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3751
Mailing Address - Country:US
Mailing Address - Phone:812-284-0660
Mailing Address - Fax:812-284-3822
Practice Address - Street 1:302 W 14TH ST STE 100
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3751
Practice Address - Country:US
Practice Address - Phone:812-284-0660
Practice Address - Fax:812-284-3822
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003402A152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100015250Medicaid
KYV11740Medicare UPIN
KY5375220006Medicare NSC
KY0959011Medicare PIN
KY7100015250Medicaid