Provider Demographics
NPI:1770583940
Name:ROBINSON, TIMOTHY PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:PAUL
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16088 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-3802
Mailing Address - Country:US
Mailing Address - Phone:800-505-6147
Mailing Address - Fax:800-505-6147
Practice Address - Street 1:16088 LEE HWY
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-3802
Practice Address - Country:US
Practice Address - Phone:800-505-6147
Practice Address - Fax:800-505-6147
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350001048Medicare ID - Type Unspecified
VAU71416Medicare UPIN