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General NPI Number Information
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NPI Number | 1699872036
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Entity Type | Individual
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Provider Name | MARK STEPHEN ROBINSON OD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 1655 HWY 65 SOUTH
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City | LAKE VILLAGE
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State | AR
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Zip | 71653
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Country | US
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Telephone | 870-265-2274
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Fax | 870-265-2325
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Provider Business Mailing Address
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Address Line | PO BOX 672
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-0672
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Country | US
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Telephone | 870-265-2274
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Fax | 870-265-2325
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2340
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License Number State | AR
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