MEDICARE: DR. TARA S ROBINSON M.D.

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	207Q00000X	Family Medicine Physician	35-07-8608-R	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689677890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA S ROBINSON M.D.

Provider Business Mailing Address
First Line	:	4330 NAVARRE AVE
Second Line	:	STE 103
City	:	OREGON
State	:	OH
Zip	:	43616-3587
Country	:	US
Telephone Number	:	419-691-7820
Fax Number	:	419-691-7593

Provider Business Practice Location Address
First Line	:	4330 NAVARRE AVE
Second Line	:	STE 103
City	:	OREGON
State	:	OH
Zip	:	43616-3587
Country	:	US
Telephone Number	:	419-691-7820
Fax Number	:	419-691-7593

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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