Healthcare Provider Details

I. General information

NPI: 1730700287
Provider Name (Legal Business Name): MICHAEL ANTHONY ROBINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050A 2ND ST SE
KIRTLAND AFB NM
87117-1809
US

IV. Provider business mailing address

500 S PRESTON ST RM 305
LOUISVILLE KY
40202-1702
US

V. Phone/Fax

Practice location:
  • Phone: 505-846-3200
  • Fax:
Mailing address:
  • Phone: 502-852-8696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01091514A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: