Provider Demographics
NPI:1003871773
Name:ROBINSON, SCOTT V (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:V
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:SCOTT
Other - Middle Name:V
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1115 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-1444
Mailing Address - Country:US
Mailing Address - Phone:616-527-0707
Mailing Address - Fax:
Practice Address - Street 1:1115 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-1444
Practice Address - Country:US
Practice Address - Phone:616-527-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT33117Medicare UPIN
MI0C45174Medicare ID - Type UnspecifiedPROVIDER CODE