Provider Demographics
NPI:1356425995
Name:HUSTON, ROBINETTE JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBINETTE
Middle Name:JEAN
Last Name:HUSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3160 FISHER PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2678
Mailing Address - Country:US
Mailing Address - Phone:614-538-1732
Mailing Address - Fax:614-734-1900
Practice Address - Street 1:5130 BRADENTON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-7557
Practice Address - Country:US
Practice Address - Phone:614-734-1100
Practice Address - Fax:614-734-1900
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0981540Medicaid
OHF35543Medicare UPIN
OHHU0723054Medicare ID - Type Unspecified