Provider Demographics
NPI:1104032325
Name:ROBINSON, TONYA ALISA (DO)
Entity Type:Individual
Prefix:DR
First Name:TONYA
Middle Name:ALISA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TONYA
Other - Middle Name:ALISA
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:214 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-5446
Mailing Address - Country:US
Mailing Address - Phone:706-647-9627
Mailing Address - Fax:706-647-9651
Practice Address - Street 1:214 CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-5446
Practice Address - Country:US
Practice Address - Phone:706-647-9627
Practice Address - Fax:706-647-9651
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62120207V00000X
GA062120207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA212488331AMedicaid
GA212488331AMedicaid