Provider Demographics
NPI:1891903274
Name:ROBINSON, JIMMY (JAMES) WESLEY (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JIMMY (JAMES)
Middle Name:WESLEY
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:3400 W TECUMSEH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1810
Mailing Address - Country:US
Mailing Address - Phone:405-360-6764
Mailing Address - Fax:405-360-6769
Practice Address - Street 1:3400 W TECUMSEH RD STE 103
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1810
Practice Address - Country:US
Practice Address - Phone:405-360-6764
Practice Address - Fax:405-360-6769
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2013-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200307550 AMedicaid