Provider Demographics
NPI:1639177165
Name:ROBBINS, DONALD E (OD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:OD
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 549
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-0549
Mailing Address - Country:US
Mailing Address - Phone:260-569-9550
Mailing Address - Fax:260-569-9244
Practice Address - Street 1:106 W BOGGSTOWN RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-9706
Practice Address - Country:US
Practice Address - Phone:317-398-9793
Practice Address - Fax:317-392-3444
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001544A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN3989793OtherMETLIFE
INP01691122OtherRAILROAD MEDICRE
IN351381529OtherTRIWEST HEALTHCARE ALLIAN
INP01691122OtherRAILROAD MEDICARE
IN5426545OtherCCN
IN000000079075OtherANTHEM
IN135012OtherCOLE MANAGED VISION
IN4524990OtherAETNA
IN10012OtherHEALTHSOURCE
IN100150100AMedicaid
IN100150100AMedicaid
IN669220024Medicare PIN
IN4524990OtherAETNA
IN2399540001Medicare NSC