Provider Demographics
NPI:1750464145
Name:JAMES, ROBBIE D (RD LD)
Entity Type:Individual
Prefix:MS
First Name:ROBBIE
Middle Name:D
Last Name:JAMES
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:MS
Other - First Name:ROBBIE
Other - Middle Name:D
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LD
Mailing Address - Street 1:PO BOX 26433
Mailing Address - Street 2:3225 IMPERIAL DRIVE
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31221-6433
Mailing Address - Country:US
Mailing Address - Phone:478-501-2400
Mailing Address - Fax:
Practice Address - Street 1:657 HEMLOCK ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8329
Practice Address - Country:US
Practice Address - Phone:478-501-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD001283133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered