Provider Demographics
NPI:1154970077
Name:STINSON, ROBERT SCOTT
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SCOTT
Last Name:STINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HOSPITAL PERIMETER RD # 104
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-8502
Mailing Address - Country:US
Mailing Address - Phone:762-777-7800
Mailing Address - Fax:478-633-3235
Practice Address - Street 1:106 HOSPITAL PERIMETER RD
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-8502
Practice Address - Country:US
Practice Address - Phone:762-777-7800
Practice Address - Fax:478-633-3235
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA96005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine