Provider Demographics
NPI:1891741666
Name:PAIGE, ROBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:PAIGE
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:PO BOX 50360
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0360
Mailing Address - Country:US
Mailing Address - Phone:806-351-1560
Mailing Address - Fax:806-351-0343
Practice Address - Street 1:6819 PLUM CREEK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1602
Practice Address - Country:US
Practice Address - Phone:806-463-1789
Practice Address - Fax:806-355-2469
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7230207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8H4660OtherBLUE CROSS & BLUE SHIELD
TX8D3747Medicare PIN
8H4660OtherBLUE CROSS & BLUE SHIELD