Provider Demographics
NPI:1821299645
Name:ROBBIE R. ATKINSON, DDS,MD,LTD.
Entity Type:Organization
Organization Name:ROBBIE R. ATKINSON, DDS,MD,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIQUINTA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIPES
Authorized Official - Suffix:
Authorized Official - Credentials:RDA, OM
Authorized Official - Phone:870-534-7860
Mailing Address - Street 1:1801 W 40TH AVE
Mailing Address - Street 2:STE. 2-A
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-6940
Mailing Address - Country:US
Mailing Address - Phone:870-534-7860
Mailing Address - Fax:870-534-5327
Practice Address - Street 1:1801 W 40TH AVE
Practice Address - Street 2:STE. 2-A
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6940
Practice Address - Country:US
Practice Address - Phone:870-534-7860
Practice Address - Fax:870-534-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2328302R00000X
ARC5909305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered302R00000XManaged Care OrganizationsHealth Maintenance Organization
Not Answered305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR2328OtherDENTIST
ARC5909OtherMEDICAL LICENSE
AR50161OtherBCBS PROVIDER