Healthcare Provider Details

I. General information

NPI: 1215931076
Provider Name (Legal Business Name): JAMES C ROBINSON O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8245 FARNSWORTH RD STE A
WATERVILLE OH
43566-9478
US

IV. Provider business mailing address

8245 FARNSWORTH RD SUITE A
WATERVILLE OH
43566-9478
US

V. Phone/Fax

Practice location:
  • Phone: 419-878-3937
  • Fax: 419-878-3947
Mailing address:
  • Phone: 419-878-3937
  • Fax: 419-878-3947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3632/T620
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: