Provider Demographics
NPI:1245628007
Name:ROBESON FAMILY HEALTHCARE, PC
Entity type:Organization
Organization Name:ROBESON FAMILY HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OBEDA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:910-536-1896
Mailing Address - Street 1:220 WINTERGREEN DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2376
Mailing Address - Country:US
Mailing Address - Phone:910-536-1896
Mailing Address - Fax:910-536-1935
Practice Address - Street 1:220 WINTERGREEN DR
Practice Address - Street 2:SUITE A
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2376
Practice Address - Country:US
Practice Address - Phone:910-536-1896
Practice Address - Fax:910-536-1935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF0311109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty