Provider Demographics
NPI:1023034139
Name:ROBINSON, GENE L (MD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 E REZANOF DR
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-6602
Mailing Address - Country:US
Mailing Address - Phone:907-486-9580
Mailing Address - Fax:907-486-9586
Practice Address - Street 1:1915 E REZANOF DR
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-6602
Practice Address - Country:US
Practice Address - Phone:907-486-9580
Practice Address - Fax:907-486-9586
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6785208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
00D0063349OtherHMSA
HI054955-01Medicaid
C63341OtherLIMSA
HIBDTBRMedicare PIN
HI054955-01Medicaid
H103429Medicare PIN
00D0063349OtherHMSA