MEDICARE: DR. DARRYL D ROBINSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	22361	OK

General Provider Information

NPI Number	:	1083686422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARRYL D ROBINSON MD

Provider Business Mailing Address
First Line	:	3110 SW 89TH ST
Second Line	:	SUITE 102
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7920
Country	:	US
Telephone Number	:	405-703-4950
Fax Number	:	405-703-4955

Provider Business Practice Location Address
First Line	:	3110 SW 89TH ST
Second Line	:	SUITE 102
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7920
Country	:	US
Telephone Number	:	405-703-4950
Fax Number	:	405-703-4955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	08/03/2015

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