Provider Demographics
NPI:1356390876
Name:ROBB, PHILIP K (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:K
Last Name:ROBB
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3400 C OLD MILTON PKWY
Mailing Address - Street 2:STE 575
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:770-410-0202
Mailing Address - Fax:770-410-0995
Practice Address - Street 1:3400 C OLD MILTON PKWY
Practice Address - Street 2:STE 575
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:770-410-0202
Practice Address - Fax:770-410-0995
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2011-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA033184207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F09579Medicare UPIN
04BDBGVMedicare ID - Type Unspecified