Provider Demographics
NPI:1649254228
Name:ROBINETTE, JOHN W (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:ROBINETTE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1801 W 40TH AVE
Mailing Address - Street 2:SUITE 6B
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-6900
Mailing Address - Country:US
Mailing Address - Phone:870-534-8500
Mailing Address - Fax:870-535-0801
Practice Address - Street 1:1801 W 40TH AVE
Practice Address - Street 2:SUITE 6B
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6900
Practice Address - Country:US
Practice Address - Phone:870-534-8500
Practice Address - Fax:870-535-0801
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR165213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1356525026Medicaid
AR1356525026Medicaid
AR7111Medicare PIN