Healthcare Provider Details

I. General information

NPI: 1467655340
Provider Name (Legal Business Name): JENNIFER D ROBINSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10035 SLIDING HILL RD
ASHLAND VA
23005-7953
US

IV. Provider business mailing address

10035 SLIDING HILL RD
ASHLAND VA
23005-7953
US

V. Phone/Fax

Practice location:
  • Phone: 804-550-7800
  • Fax: 804-550-7904
Mailing address:
  • Phone: 804-550-7800
  • Fax: 804-550-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number0101240601
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: