Provider Demographics
NPI:1194861534
Name:ROBINSON, RICHARD J (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
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 1:700 WEST IRONWOOD DRIVE
Mailing Address - Street 2:SUITE 336
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4485
Mailing Address - Country:US
Mailing Address - Phone:208-765-1252
Mailing Address - Fax:208-765-1494
Practice Address - Street 1:700 WEST IRONWOOD DRIVE
Practice Address - Street 2:SUITE 336
Practice Address - City:COEUR D'ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4485
Practice Address - Country:US
Practice Address - Phone:208-765-1252
Practice Address - Fax:208-765-1494
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM5262207RP1001X
IDM-5262207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID001870900Medicaid
ID1119710Medicare ID - Type Unspecified
ID001870900Medicaid