Provider Demographics
NPI:1801040803
Name:DONALD E ROBBINS, O.D.
Entity Type:Organization
Organization Name:DONALD E ROBBINS, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-398-9793
Mailing Address - Street 1:106 W BOGGSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-9706
Mailing Address - Country:US
Mailing Address - Phone:317-398-9793
Mailing Address - Fax:317-392-3444
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001544A152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0181970001Medicare NSC