Provider Demographics
NPI:1952300154
Name:DRISKILL, ROBERT LEROY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEROY
Last Name:DRISKILL
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 1:111 OAKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2035
Mailing Address - Country:US
Mailing Address - Phone:434-944-4310
Mailing Address - Fax:434-384-9185
Practice Address - Street 1:111 OAKWOOD PL
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2035
Practice Address - Country:US
Practice Address - Phone:434-944-4310
Practice Address - Fax:434-384-9185
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010424992085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA032409OtherANTHEM BCBS
VA007239271Medicaid
VA007239271Medicaid
VA032409OtherANTHEM BCBS