Provider Demographics
NPI:1760681845
Name:ROBINETTE MEDICAL CLINIC, P.A.
Entity Type:Organization
Organization Name:ROBINETTE MEDICAL CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-932-2423
Mailing Address - Street 1:801 OSLER DR STE A
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4329
Mailing Address - Country:US
Mailing Address - Phone:870-932-2423
Mailing Address - Fax:870-932-1225
Practice Address - Street 1:801 OSLER DR STE A
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4329
Practice Address - Country:US
Practice Address - Phone:870-932-2423
Practice Address - Fax:870-932-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC3151207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR117843002Medicaid
AR5B041Medicare PIN
AR117843002Medicaid