Provider Demographics
NPI:1205897857
Name:TROTMAN, ROBIN L (DO)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:TROTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6473
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:3800 S NATIONAL AVE
Practice Address - Street 2:LL100
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5209
Practice Address - Country:US
Practice Address - Phone:417-269-7784
Practice Address - Fax:417-269-6721
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004005145207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO211862OtherANTHEM
MO200901007Medicaid
MO200901007Medicaid
NC2402877Medicare ID - Type Unspecified
MOP00375516Medicare PIN
I46386Medicare UPIN