Provider Demographics
NPI:1083686422
Name:ROBINSON, DARRYL D (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:D
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 1:3110 SW 89TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7920
Mailing Address - Country:US
Mailing Address - Phone:405-703-4950
Mailing Address - Fax:405-703-4955
Practice Address - Street 1:3110 SW 89TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7920
Practice Address - Country:US
Practice Address - Phone:405-703-4950
Practice Address - Fax:405-703-4955
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22361208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG54829Medicare UPIN
OK250013389OtherRAILROAD MEDICARE
OK1000032540AMedicaid