MEDICARE: MR. ROBERT LEE ROBINSON JR. APRN

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	2084P0800X	Psychiatry Physician	1-147094	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-147094	OTHER	AL	PSYCHIATRY
2	1-147094	OTHER	AL	ALABAMA BOARD OF NURSING

General Provider Information

NPI Number	:	1518622380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT LEE ROBINSON JR. APRN

Provider Business Mailing Address
First Line	:	3636 OAK RIDGE LN
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-9318
Country	:	US
Telephone Number	:	404-840-4186
Fax Number	:

Provider Business Practice Location Address
First Line	:	3636 OAK RIDGE LN
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-9318
Country	:	US
Telephone Number	:	404-840-4186
Fax Number	:

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

Provider Enumeration Date	:	11/05/2021
Last Update Date	:	11/05/2021

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