Basic Information
| Provider Information | |||||||||
| NPI: | 1154499978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | REGINALD | ||||||||
| MiddleName: | JEROME | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314012917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125271088 | ||||||||
| FaxNumber: | 9125271126 | ||||||||
| Practice Location | |||||||||
| Address1: | 5354 REYNOLDS ST STE 420 | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314056011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125271000 | ||||||||
| FaxNumber: | 9125271155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 07/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 46638 | GA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 174400000X | 46638 | GA | N | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 00813084A | 05 | GA | MEDICAID | 160051842 | 01 | GA | RR MEDICARE | OTHER | G46638 | 01 | SC | SC MEDICAID | OTHER |