Provider Demographics
NPI:1205891892
Name:OUKROP, ROBIN B (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:B
Last Name:OUKROP
Suffix:
Gender:F
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:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:2051 CLEVIDENCE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-2278
Practice Address - Country:US
Practice Address - Phone:812-280-9145
Practice Address - Fax:812-280-6627
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01046754A207R00000X
KY31326207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1193597OtherCHA / NCMA
KY7100057420Medicaid
IN110158913OtherRAILROAD MEDICARE
KY00000050934OtherANTHEM / NCMA
IN200139930Medicaid
KY000023031HOtherHUMANA / NCMA
KY2447923000OtherPASSPORT ADVANTAGE / NCMA
KY8963677OtherCIGNA / NCMA
KY1361941Medicare PIN
IN200139930Medicaid
IN196290QMedicare PIN