Provider Demographics
NPI:1629184593
Name:ROBBINS, EDWIN BRIAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:BRIAN
Last Name:ROBBINS
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 22756
Mailing Address - Street 2:STE. 105
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40522-2756
Mailing Address - Country:US
Mailing Address - Phone:859-264-1815
Mailing Address - Fax:859-264-1820
Practice Address - Street 1:120 N EAGLE CREEK DR
Practice Address - Street 2:STE. 101
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1827
Practice Address - Country:US
Practice Address - Phone:859-967-5309
Practice Address - Fax:859-967-5346
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2016-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYPA 817363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95006219Medicaid
KY7100194690Medicaid
KYQ21854Medicare UPIN
KY7100194690Medicaid
KY01096002Medicare PIN