Healthcare Provider Details

I. General information

NPI: 1477618288
Provider Name (Legal Business Name): WILLIAM E. ROBINSON JR. OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 E.MT.VERNON STREET
SOMERSET KY
42501
US

IV. Provider business mailing address

709 E.MT.VERNON STREET
SOMERSET KY
42501
US

V. Phone/Fax

Practice location:
  • Phone: 606-679-5177
  • Fax: 606-678-9200
Mailing address:
  • Phone: 606-679-5177
  • Fax: 606-678-9200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number805DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: