Provider Demographics
NPI:1245434117
Name:ROBSON, RAYMOND R III (RPH, DPH)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:R
Last Name:ROBSON
Suffix:III
Gender:M
Credentials:RPH, DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:MC DERMOTT
Mailing Address - State:OH
Mailing Address - Zip Code:45652-8941
Mailing Address - Country:US
Mailing Address - Phone:740-259-2984
Mailing Address - Fax:
Practice Address - Street 1:495 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:MC DERMOTT
Practice Address - State:OH
Practice Address - Zip Code:45652-8941
Practice Address - Country:US
Practice Address - Phone:740-259-2984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-25118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist