Healthcare Provider Details

I. General information

NPI: 1376507962
Provider Name (Legal Business Name): ROBERT J ROBINE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 LITTLE BLUE PKWY SUITE 300
INDEPENDENCE MO
64057-8312
US

IV. Provider business mailing address

4200 LITTLE BLUE PKWY SUITE300
INDEPENDENCE MO
64057-8312
US

V. Phone/Fax

Practice location:
  • Phone: 816-353-2700
  • Fax: 816-795-7311
Mailing address:
  • Phone: 816-353-2700
  • Fax: 816-795-7311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR7N58
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: