Provider Demographics
NPI:1013919075
Name:ROBBINS, SAMUEL GWIN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:GWIN
Last Name:ROBBINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7655 POPLAR AVE
Mailing Address - Street 2:STE 350
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3957
Mailing Address - Country:US
Mailing Address - Phone:901-761-2470
Mailing Address - Fax:901-767-4898
Practice Address - Street 1:7655 POPLAR AVE
Practice Address - Street 2:STE 350
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3957
Practice Address - Country:US
Practice Address - Phone:901-761-2470
Practice Address - Fax:901-767-4898
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD8612208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3906OtherTLC TENNCARE
MO201906401Medicaid
TN153038OtherUNISON TENNCARE
TN3092503OtherBCBS OF TN
AR106803001Medicaid
TN3191899Medicaid
TN3906OtherTLC TENNCARE
D32191Medicare UPIN
MO201906401Medicaid