Provider Demographics
NPI:1114017449
Name:ROBINSON, DENNIS ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:ALLEN
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 1:105 SPANISH CT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1282
Mailing Address - Country:US
Mailing Address - Phone:229-438-7100
Mailing Address - Fax:229-438-9382
Practice Address - Street 1:105 SPANISH CT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-1282
Practice Address - Country:US
Practice Address - Phone:229-438-7100
Practice Address - Fax:229-438-9382
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA26178207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000286371EMedicaid
GA1093997447OtherGROUP NPI
GA000286371EMedicaid
GA03BDBFQMedicare Oscar/Certification
GA1093997447OtherGROUP NPI