Healthcare Provider Details

I. General information

NPI: 1770534299
Provider Name (Legal Business Name): DAN EDWARD ROBINSON D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 S 4TH TRAFFICWAY 112A
LEAVENWORTH KS
66048
US

IV. Provider business mailing address

3908 W 66TH ST
PRAIRIE VILLAGE KS
66208-1639
US

V. Phone/Fax

Practice location:
  • Phone: 913-682-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number000493
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: