Provider Demographics
NPI:1356331169
Name:THOMPSON, ROBIN K (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:K
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64586 BALK RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-9621
Mailing Address - Country:US
Mailing Address - Phone:269-651-9048
Mailing Address - Fax:
Practice Address - Street 1:600 S LAKEVIEW ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-2371
Practice Address - Country:US
Practice Address - Phone:269-651-3174
Practice Address - Fax:269-659-0182
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRT053034207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP19880001Medicare ID - Type Unspecified