Provider Demographics
NPI:1891739322
Name:PILKINTON, ROBERT DALE JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DALE
Last Name:PILKINTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N
Mailing Address - Street 2:SUITE 504
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2131
Mailing Address - Country:US
Mailing Address - Phone:615-329-7890
Mailing Address - Fax:615-329-7892
Practice Address - Street 1:300 20TH AVE N
Practice Address - Street 2:SUITE 504
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2131
Practice Address - Country:US
Practice Address - Phone:615-329-7890
Practice Address - Fax:615-329-7892
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26332207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3028494OtherBLUE CROSS BLUE SHIELD
TN3090626Medicaid
TN1031043OtherAETNA
TN0840148OtherUNITED HEALTH CARE
TN3090626Medicaid
TN3028494OtherBLUE CROSS BLUE SHIELD