Provider Demographics
NPI:1033477088
Name:TOLBERT, ROBIN NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:NICOLE
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4190
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4190
Mailing Address - Country:US
Mailing Address - Phone:304-908-9201
Mailing Address - Fax:304-935-3334
Practice Address - Street 1:1 CHATEAU LN
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1627
Practice Address - Country:US
Practice Address - Phone:304-736-4700
Practice Address - Fax:304-736-4029
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP056207Q00000X
KY04205207Q00000X
WV2791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0138433Medicaid