Provider Demographics
NPI:1578516399
Name:ROBINSON, THOMAS L (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:118 DILLON DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1018
Practice Address - Country:US
Practice Address - Phone:864-560-9056
Practice Address - Fax:864-560-9057
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7739207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00386920OtherMEDICARE RAILROAD PTAN#
SC77393Medicaid
SCP01397040OtherRAILROAD MEDICARE
SC77393Medicaid
GAP00386920OtherMEDICARE RAILROAD PTAN#
SC8688Medicare PIN
SCSC37255019Medicare PIN
D99170Medicare UPIN