Provider Demographics
NPI:1952915902
Name:ROBINSON, COURTNEY (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5436 S MINGO RD STE B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5740
Mailing Address - Country:US
Mailing Address - Phone:918-340-5140
Mailing Address - Fax:
Practice Address - Street 1:5436 S MINGO RD STE B
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-5740
Practice Address - Country:US
Practice Address - Phone:918-340-5140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-06
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management