Provider Demographics
NPI:1528388717
Name:VALENTINE, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3333
Mailing Address - Country:US
Mailing Address - Phone:918-488-6687
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:1801 E KENOSHA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-2098
Practice Address - Country:US
Practice Address - Phone:918-449-4150
Practice Address - Fax:918-449-4107
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2018-11-16
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Provider Licenses
StateLicense IDTaxonomies
OK27774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200292990AMedicaid
OKP01217631OtherRAILROAD MEDICARE
299786YRHZMedicare PIN