Healthcare Provider Details

I. General information

NPI: 1265568216
Provider Name (Legal Business Name): JAMIE ROBYN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 S BURNETT RD
SPRINGFIELD OH
45505-2720
US

IV. Provider business mailing address

6696 ELMERS CT
WORTHINGTON OH
43085-2976
US

V. Phone/Fax

Practice location:
  • Phone: 937-328-3385
  • Fax:
Mailing address:
  • Phone: 614-582-5629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.074038
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: