Provider Demographics
NPI:1548234727
Name:KINGMAN, ROBERT G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:KINGMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:401 HOSPITAL DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-2415
Mailing Address - Country:US
Mailing Address - Phone:903-872-3005
Mailing Address - Fax:903-872-3050
Practice Address - Street 1:301 HOSPITAL DR
Practice Address - Street 2:SUITE 170
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2471
Practice Address - Country:US
Practice Address - Phone:903-872-3005
Practice Address - Fax:903-875-7210
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG3521208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y226OtherMEDICARE GROUP
TXP00463090OtherRAILROAD MEDICARE
TXDG9311OtherRAILROAD MEDICARE GROUP
TX110533005Medicaid
TX8F6250Medicare PIN
TXDG9311OtherRAILROAD MEDICARE GROUP