Provider Demographics
NPI:1396842605
Name:THURMAN, ROBIN D (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:THURMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-269-7241
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:1150 STATE HIGHWAY 248 STE 202
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-3729
Practice Address - Country:US
Practice Address - Phone:417-348-8964
Practice Address - Fax:417-336-2705
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO110093363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
144172OtherBCBS
080174333OtherRAILROAD MEDICARE
MO205804610Medicaid
14189OtherCOX HEALTH SYSTEMS
462206OtherHEALTHLINK