Provider Demographics
NPI:1215931076
Name:ROBINSON, JAMES C (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8245 FARNSWORTH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566-9478
Mailing Address - Country:US
Mailing Address - Phone:419-878-3937
Mailing Address - Fax:419-878-3947
Practice Address - Street 1:8245 FARNSWORTH RD STE A
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-9478
Practice Address - Country:US
Practice Address - Phone:419-878-3937
Practice Address - Fax:419-878-3947
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3632/T620152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0513804Medicaid
OH0513804Medicaid
OHRO0515511Medicare PIN
OH0518430001Medicare NSC
OH410014782Medicare PIN