Healthcare Provider Details

I. General information

NPI: 1194861534
Provider Name (Legal Business Name): RICHARD J ROBINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WEST IRONWOOD DRIVE SUITE 336
COEUR D'ALENE ID
83814-4485
US

IV. Provider business mailing address

700 WEST IRONWOOD DRIVE SUITE 336
COEUR D'ALENE ID
83814-4485
US

V. Phone/Fax

Practice location:
  • Phone: 208-765-1252
  • Fax: 208-765-1494
Mailing address:
  • Phone: 208-765-1252
  • Fax: 208-765-1494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberM5262
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberM-5262
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: