Provider Demographics
NPI:1841218955
Name:ROBKE, JASON M (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:M
Last Name:ROBKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 KOLBE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1652
Mailing Address - Country:US
Mailing Address - Phone:440-222-4567
Mailing Address - Fax:440-960-6435
Practice Address - Street 1:3600 KOLBE RD STE 210
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1652
Practice Address - Country:US
Practice Address - Phone:440-222-4567
Practice Address - Fax:440-960-6435
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-084902208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
7042623OtherAETNA
363959OtherWELLCARE
000000221224OtherUNISON
000000503668OtherANTHEM
741760OtherBUCKEYE
OH2495205Medicaid
000000503668OtherANTHEM
I16086Medicare UPIN
OHP00397856Medicare PIN
363959OtherWELLCARE