Provider Demographics
NPI:1558555292
Name:GEORGE, ROBERT JAMES (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:GEORGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 LAKEWOOD RANCH BLVD
Mailing Address - Street 2:LAKE ERIE COLLEGE OSTEOPATHIC MEDICINE BRADENTON CAMPUS
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4909
Mailing Address - Country:US
Mailing Address - Phone:941-782-5657
Mailing Address - Fax:941-782-5737
Practice Address - Street 1:5000 LAKEWOOD RANCH BLVD
Practice Address - Street 2:LAKE ERIE COLLEGE OSTEOPATHIC MEDICINE BRADENTON CAMPUS
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-4909
Practice Address - Country:US
Practice Address - Phone:941-782-5657
Practice Address - Fax:941-782-5737
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6741207P00000X, 207Q00000X
OH34001900207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine