Provider Demographics
NPI:1932386364
Name:FRANK ROBINSON JR OD PC
Entity Type:Organization
Organization Name:FRANK ROBINSON JR OD PC
Other - Org Name:ROBINSON FAMILY EYECARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:260-203-5905
Mailing Address - Street 1:6710 OLD TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46809-2639
Mailing Address - Country:US
Mailing Address - Phone:260-203-5905
Mailing Address - Fax:260-218-1802
Practice Address - Street 1:6710 OLD TRAIL RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46809-2639
Practice Address - Country:US
Practice Address - Phone:260-203-5905
Practice Address - Fax:260-218-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002274152W00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100257880 HMedicaid
ININ2147Medicare UPIN