Provider Demographics
NPI:1851387294
Name:ROBINSON, JAMES L (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-9036
Mailing Address - Country:US
Mailing Address - Phone:937-599-1280
Mailing Address - Fax:937-599-1730
Practice Address - Street 1:2221 TIMBER TRL
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-9036
Practice Address - Country:US
Practice Address - Phone:937-599-1280
Practice Address - Fax:937-599-1730
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50000842363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0077579Medicaid
OHP56002Medicare UPIN
OH0077579Medicaid