Provider Demographics
NPI:1033396908
Name:DECKER, ROBERT COURTNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:COURTNEY
Last Name:DECKER
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 1:1600 SW ARCHER RD # 112727
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3450 HULL ROAD, RM 3341
Practice Address - Street 2:UF ORTHOPAEDICS AND SPORTS MED INSTITUTE
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607
Practice Address - Country:US
Practice Address - Phone:352-273-7001
Practice Address - Fax:352-273-7388
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000894207X00000X
CAA103280207X00000X
FLME 105276207XS0117X
FLME105276207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001540000Medicaid
FLCN594ZMedicare PIN