Provider Demographics
NPI:1154397818
Name:ROOKSTOOL, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:ROOKSTOOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 BAYVIEW RD
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-9778
Mailing Address - Country:US
Mailing Address - Phone:360-221-0223
Mailing Address - Fax:
Practice Address - Street 1:1211 24TH STREET
Practice Address - Street 2:ISLAND HOSPITAL
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-4927
Practice Address - Country:US
Practice Address - Phone:360-299-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032276207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5694ROOtherBSWA
WA8161531Medicaid
WA6075ROOtherBSWA
WA6075ROOtherBSWA