MEDICARE: DR. ROBIN LINDELL STEVENSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	12183	OK

General Provider Information

NPI Number	:	1609811801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN LINDELL STEVENSON MD

Provider Business Mailing Address
First Line	:	100 REMINGTON PL
Second Line	:
City	:	TAHLEQUAH
State	:	OK
Zip	:	74464-4168
Country	:	US
Telephone Number	:	918-457-9017
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 US HWY 412
Second Line	:
City	:	COLCORD
State	:	OK
Zip	:	74338-4168
Country	:	US
Telephone Number	:	918-422-5750
Fax Number	:	918-422-4351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	03/02/2017

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