Healthcare Provider Details

I. General information

NPI: 1952370942
Provider Name (Legal Business Name): ROBERT PAUL TROMBLEY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 NE 13TH ST
OKLAHOMA CITY OK
73104-5007
US

IV. Provider business mailing address

9501 N OAK TRFY
KANSAS CITY MO
64155-2256
US

V. Phone/Fax

Practice location:
  • Phone: 405-456-5219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number492
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2005036331
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1372
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: