Provider Demographics
NPI:1538508106
Name:ROBINSON, WILLIE DANIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIE
Middle Name:DANIEL
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1578 US HIGHWAY 19 S
Mailing Address - Street 2:APT 1713
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-4940
Mailing Address - Country:US
Mailing Address - Phone:205-613-6141
Mailing Address - Fax:
Practice Address - Street 1:2351 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2435
Practice Address - Country:US
Practice Address - Phone:229-888-6166
Practice Address - Fax:229-888-6260
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist