Healthcare Provider Details

I. General information

NPI: 1386911881
Provider Name (Legal Business Name): MR. ANTHONY S ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 NW 39TH TER
OKLAHOMA CITY OK
73112-8710
US

IV. Provider business mailing address

1401 NW 104TH TER
OKLAHOMA CITY OK
73114-5107
US

V. Phone/Fax

Practice location:
  • Phone: 405-557-1655
  • Fax: 504-525-0677
Mailing address:
  • Phone: 405-286-2315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: