Basic Information
| Provider Information | |||||||||
| NPI: | 1275539090 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 745 HASKINS RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434021600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193537069 | ||||||||
| FaxNumber: | 4193537076 | ||||||||
| Practice Location | |||||||||
| Address1: | 209 BRIAR HILL RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | NORTH BALTIMORE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458729349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192571417 | ||||||||
| FaxNumber: | 4192577408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2005 | ||||||||
| LastUpdateDate: | 05/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35056181 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 344428256 | 01 | OH | OHIO HEALTH CARE | OTHER | 4487343 | 01 | OH | AETNA | OTHER | PH00157916 | 01 | OH | NATIONWIDE | OTHER | 142211 | 01 | OH | CARE CHOICES | OTHER | 20076 | 01 | MI | HPM HEALTH PLAN OF MI | OTHER | 2331542 | 05 | OH | MEDICAID | 000000213516 | 01 | OH | ANTHEM MEDICAID | OTHER | 01513 | 01 | OH | PARAMOUNT | OTHER | 344428256 | 01 | CA | BEECH STREET | OTHER | 000000231516 | 01 | OH | ANTHEM-COMMERICAL | OTHER | 344428256076 | 01 | OH | CARESOURCES | OTHER | 4427891 | 05 | MI | MEDICAID | 142211 | 01 | OH | PRIORITY HEALTH | OTHER | 344428256 | 01 | OH | EMERALD | OTHER | 7073182005 | 01 | OH | CIGNA | OTHER |