Healthcare Provider Details

I. General information

NPI: 1558986869
Provider Name (Legal Business Name): JOHN LUKE ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4778 OVERTON RD
BIRMINGHAM AL
35210-3803
US

IV. Provider business mailing address

4778 OVERTON RD
BIRMINGHAM AL
35210-3803
US

V. Phone/Fax

Practice location:
  • Phone: 205-957-0294
  • Fax:
Mailing address:
  • Phone: 205-957-0294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: