Provider Demographics
NPI:1154316610
Name:ROBINSON, COLIN RICHARD (OD)
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:RICHARD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 ROOSEVELT TRL
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-4904
Mailing Address - Country:US
Mailing Address - Phone:207-892-3216
Mailing Address - Fax:207-892-0082
Practice Address - Street 1:584 ROOSEVELT TRL
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4904
Practice Address - Country:US
Practice Address - Phone:207-892-3216
Practice Address - Fax:207-892-0082
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0000583152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ROMM6520Medicare ID - Type Unspecified
T31311Medicare UPIN