Provider Demographics
NPI:1497737324
Name:ROBBINS, ROBERT E (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:ROBBINS
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 1:1107 CROWN POINTE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7123
Mailing Address - Country:US
Mailing Address - Phone:270-982-1200
Mailing Address - Fax:270-234-1952
Practice Address - Street 1:1107 CROWN POINTE DR
Practice Address - Street 2:SUITE C
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7123
Practice Address - Country:US
Practice Address - Phone:270-982-1200
Practice Address - Fax:270-234-1952
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13533208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64135338Medicaid
KYP00626472OtherRAILROAD MEDICARE PTAN
KYP00626472OtherRAILROAD MEDICARE PTAN
KY64135338Medicaid
KY00107001Medicare PIN
KY00189001Medicare PIN