Provider Demographics
NPI:1801861059
Name:ROBESON, JAMES A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:ROBESON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1118 ROSS CLARK CIR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3001
Mailing Address - Country:US
Mailing Address - Phone:334-794-3192
Mailing Address - Fax:334-792-7513
Practice Address - Street 1:1118 ROSS CLARK CIR
Practice Address - Street 2:SUITE 303
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3001
Practice Address - Country:US
Practice Address - Phone:334-794-3192
Practice Address - Fax:334-792-7513
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2013-12-18
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Provider Licenses
StateLicense IDTaxonomies
AL17452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00894825AOtherGEORGIA MEDICAID
AL051512610OtherALABAMA BLUE CROSS
AL051552727Medicaid
ALP00031524OtherRRMC
FL81069OtherFLORIDA BLUE CROSS
AL051552727Medicare PIN
FL81069OtherFLORIDA BLUE CROSS