=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760681845
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBINETTE MEDICAL CLINIC, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2007
-----------------------------------------------------
Last Update Date | 03/17/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 OSLER DR STE A
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72401-4329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-932-2423
-----------------------------------------------------
Fax | 870-932-1225
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 OSLER DR STE A
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72401-4329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-932-2423
-----------------------------------------------------
Fax | 870-932-1225
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | FRANCES ROBINETTE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-932-2423
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | C3151
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------