Provider Demographics
NPI:1528029329
Name:ROBISON, WENDELL JESSE
Entity Type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:JESSE
Last Name:ROBISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1696 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-3243
Mailing Address - Country:US
Mailing Address - Phone:307-672-2703
Mailing Address - Fax:
Practice Address - Street 1:1898 FORT RD
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-8320
Practice Address - Country:US
Practice Address - Phone:307-672-1674
Practice Address - Fax:307-672-1639
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3736A207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine