Provider Demographics
NPI:1437228392
Name:ROBISON, ROGER FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:FRANK
Last Name:ROBISON
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 1:304 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-2810
Mailing Address - Country:US
Mailing Address - Phone:812-886-0464
Mailing Address - Fax:812-886-0464
Practice Address - Street 1:520 S 7TH ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1038
Practice Address - Country:US
Practice Address - Phone:812-885-3939
Practice Address - Fax:812-885-3974
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01022453A2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100182480Medicaid
IN000000708749OtherANTHEM PROVIDER NUMBER
IND70856Medicare UPIN
IN100182480Medicaid
IN215260BMedicare ID - Type Unspecified