Basic Information
| Provider Information | |||||||||
| NPI: | 1649521568 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL ROBINSON MEDICAL CLINIC, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1330 | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730701330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053076630 | ||||||||
| FaxNumber: | 4053076660 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 W. 2ND ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | ELK CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803039060 | ||||||||
| FaxNumber: | 5803039009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2012 | ||||||||
| LastUpdateDate: | 09/18/2014 | ||||||||
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| AuthorizedOfficialLastName: | ROBINSON | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | MD/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5809289933 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.