Provider Demographics
NPI:1326060187
Name:ROBINSON, DONALD RAY (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:RAY
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 1:1501 E MILULI AVENUE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819
Mailing Address - Country:US
Mailing Address - Phone:229-243-0152
Mailing Address - Fax:229-246-1683
Practice Address - Street 1:1501 E MILULI AVENUE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819
Practice Address - Country:US
Practice Address - Phone:229-243-0152
Practice Address - Fax:229-246-1683
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA22631207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA022631OtherMEDICAL LICENSE
GA00347289AMedicaid
GA00347289AMedicaid