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NPI Code Detail

MEDICARE: ROBERT KEITH ALBISTON

MEDICARE: ROBERT KEITH ALBISTON
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
1103TC0700XClinical PsychologistP1001TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10104517OTHERTNBLUE CROSS BLUE SHIELD TN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417090838
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT KEITH ALBISTON
Provider Business Mailing Address
First Line : 1002 BRADFORD WAY
Second Line :
City : KINGSTON
State : TN
Zip : 37763-3100
Country : US
Telephone Number : 865-376-1585
Fax Number : 865-376-1587
Provider Business Practice Location Address
First Line : 1002 BRADFORD WAY
Second Line :
City : KINGSTON
State : TN
Zip : 37763-3100
Country : US
Telephone Number : 865-376-1585
Fax Number : 865-376-1587
Authorized Official
Title or Position : OWNER
Name : DR. ROBERT K ALBISTON
Credential : PH.D.
Telephone Number : 865-375-1585
Provider Enumeration Date : 02/15/2007
Last Update Date : 08/17/2007

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Directions to “ROBERT KEITH ALBISTON ” Practice Location

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