Healthcare Provider Details

I. General information

NPI: 1457892184
Provider Name (Legal Business Name): ROBINSON MEDICAL CLINIC EAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 COLORADO AVE
ELK CITY OK
73644-2800
US

IV. Provider business mailing address

1221 COLORADO AVE
ELK CITY OK
73644-2800
US

V. Phone/Fax

Practice location:
  • Phone: 580-225-4000
  • Fax: 580-243-3408
Mailing address:
  • Phone: 580-225-4000
  • Fax: 580-243-3408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9687
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0083428
License Number StateOK

VIII. Authorized Official

Name: MRS. LINDSAY KAY ROBINSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 580-225-4000