Provider Demographics
NPI:1508820903
Name:CARSON, ROBIN MICHELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:MICHELLE
Last Name:CARSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:MICHELLE
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5010 E 68TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3305
Mailing Address - Country:US
Mailing Address - Phone:918-960-2827
Mailing Address - Fax:918-960-2824
Practice Address - Street 1:5010 E 68TH ST STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3305
Practice Address - Country:US
Practice Address - Phone:918-960-2827
Practice Address - Fax:918-250-2067
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3652207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200010990AMedicaid
OKOKA103654Medicare PIN
OK200010990AMedicaid