Basic Information
| Provider Information | |||||||||
| NPI: | 1306959242 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | RAYMOND | ||||||||
| MiddleName: | KENT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6701 AIRPORT BLVD STE B215 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366083706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516390001 | ||||||||
| FaxNumber: | 2516393194 | ||||||||
| Practice Location | |||||||||
| Address1: | 6701 AIRPORT BLVD STE B215 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366083706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516390001 | ||||||||
| FaxNumber: | 2516393194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2084N0400X | 00010413 | AL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 528401660 | 05 | AL | MEDICAID | 12952 | 05 | AL | MEDICAID |