MEDICARE: RICHARD RANDAL 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	207W00000X	Ophthalmology Physician	11333	OK

General Provider Information

NPI Number	:	1699734764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD RANDAL ROBINSON MD

Provider Business Mailing Address
First Line	:	1455 S. DOUGLAS
Second Line	:	SUITE D
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130
Country	:	US
Telephone Number	:	405-733-4545
Fax Number	:	405-733-2758

Provider Business Practice Location Address
First Line	:	1455 S. DOUGLAS
Second Line	:	SUITE D
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130
Country	:	US
Telephone Number	:	405-733-4545
Fax Number	:	405-733-2758

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

Provider Enumeration Date	:	03/18/2006
Last Update Date	:	04/16/2013

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