Provider Demographics
NPI:1972514446
Name:EVANS-ROBINSON, TINA L (MD)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:L
Last Name:EVANS-ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:415 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1230
Mailing Address - Country:US
Mailing Address - Phone:812-423-7791
Mailing Address - Fax:812-422-7558
Practice Address - Street 1:60 S STOCKWELL RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0247
Practice Address - Country:US
Practice Address - Phone:812-476-5437
Practice Address - Fax:812-422-7558
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01042654A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000200415OtherANTHEM
IN11200269OtherCAQH
IN100461100AMedicaid
IN834950IIIIOtherMEDICARE
INBE3430345OtherDEA
IN834950IIIIOtherMEDICARE