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General NPI Number Information
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NPI Number | 1649710666
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Entity Type | Individual
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Provider Name | ROBINSON O'HARA-RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 236 UFFELMAN DR
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City | CLARKSVILLE
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State | TN
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Zip | 37043-6566
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Country | US
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Telephone | 931-647-6305
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Fax | 931-245-1153
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Provider Business Mailing Address
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Address Line | 803 RIVER RUN
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City | CLARKSVILLE
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State | TN
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Zip | 37043-6042
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Country | US
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Telephone | 305-720-6210
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3179
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3179
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License Number State | TN
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