Provider Demographics
NPI:1497791792
Name:ROBINSON, TODD A (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:A
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 1:241 SILVERWOOD COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5164
Mailing Address - Country:US
Mailing Address - Phone:912-826-8820
Mailing Address - Fax:912-826-8805
Practice Address - Street 1:241 SILVERWOOD COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5164
Practice Address - Country:US
Practice Address - Phone:912-826-8820
Practice Address - Fax:912-826-8805
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041937207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000709398BOtherMEDICAID - SAVH
GA000709398DMedicaid
GA000709398AOtherMEDICAID - RINCON
GA624574OtherWELLCARE
SCG41937Medicaid
GA160051158OtherRR MEDICARE
GA160051158OtherRR MEDICARE
GA000709398DMedicaid