Provider Demographics
NPI:1902021082
Name:CONYNE, ROBERT KARLTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KARLTON
Last Name:CONYNE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4022 CLIFTON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-1144
Mailing Address - Country:US
Mailing Address - Phone:513-861-5295
Mailing Address - Fax:
Practice Address - Street 1:4022 CLIFTON RIDGE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-1144
Practice Address - Country:US
Practice Address - Phone:513-861-5295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3059174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist