Provider Demographics
NPI:1194707000
Name:ROBISON, FLOYD FADDIS (PHD HSSP)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:FADDIS
Last Name:ROBISON
Suffix:
Gender:M
Credentials:PHD HSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-9450
Mailing Address - Country:US
Mailing Address - Phone:765-318-1225
Mailing Address - Fax:180-059-6368
Practice Address - Street 1:3630 MEADOWS DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-9450
Practice Address - Country:US
Practice Address - Phone:765-318-1225
Practice Address - Fax:180-059-6368
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040289103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN255890Medicare PIN