Provider Demographics
NPI:1679676142
Name:FREEMAN, ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1210 KY HIGHWAY 36 E
Mailing Address - Street 2:SUITE G4
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-7490
Mailing Address - Country:US
Mailing Address - Phone:859-234-9955
Mailing Address - Fax:859-234-9959
Practice Address - Street 1:1210 KY HIGHWAY 36 E
Practice Address - Street 2:SUITE G4
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-7490
Practice Address - Country:US
Practice Address - Phone:859-234-9955
Practice Address - Fax:859-234-9959
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47603207V00000X
TNMD0000047603207V00000X
KY46608207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1526024Medicaid
NJ0043354Medicaid
TN103I161889Medicare PIN
NJ086532Medicare PIN
TN1526024Medicaid
NJG37949Medicare UPIN