Basic Information
| Provider Information | |||||||||
| NPI: | 1376507962 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 LITTLE BLUE PKWY | ||||||||
| Address2: | SUITE300 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640578312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163532700 | ||||||||
| FaxNumber: | 8167957311 | ||||||||
| Practice Location | |||||||||
| Address1: | 4200 LITTLE BLUE PKWY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640578312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8163532700 | ||||||||
| FaxNumber: | 8167957311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 03/13/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R7N58 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.