Provider Demographics
NPI:1033108170
Name:ROBILLARD, JEAN E (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:E
Last Name:ROBILLARD
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 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-335-8065
Mailing Address - Fax:319-335-8318
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-335-8065
Practice Address - Fax:319-335-8318
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA204872080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00848OtherWELLMARK BCBS
IA1008482Medicaid
IA00848OtherWELLMARK BCBS
A00077Medicare UPIN
IAI9859Medicare PIN