Basic Information
| Provider Information | |||||||||
| NPI: | 1801040803 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DONALD E ROBBINS, O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 W BOGGSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461769706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173989793 | ||||||||
| FaxNumber: | 3173923444 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 W BOGGSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461769706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173989793 | ||||||||
| FaxNumber: | 3173923444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2008 | ||||||||
| LastUpdateDate: | 11/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | ROBBINS | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3173989793 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | 18001544A | IN | N | Suppliers | Eyewear Supplier (Equipment, not the service) | 152W00000X | 18001544A | IN | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.