Provider Demographics
NPI:1306942412
Name:REMKE, ROBERT D (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:REMKE
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 1:250 N MILITARY AVE
Mailing Address - Street 2:PO BOX 620
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-3326
Mailing Address - Country:US
Mailing Address - Phone:931-762-5595
Mailing Address - Fax:931-766-2273
Practice Address - Street 1:250 N MILITARY AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3326
Practice Address - Country:US
Practice Address - Phone:931-762-5595
Practice Address - Fax:931-766-2273
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD1171152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3596506Medicaid
TN150348OtherBCBS
TNTN0102OtherAMERICHOICE
TN10066983OtherAMERIGROUP
TN150348OtherTNCARE SELECT
TN2240212OtherUNITED HEALTHCARE
TN8842110OtherCIGNA
TN10066983OtherAMERIGROUP
TN2240212OtherUNITED HEALTHCARE
TN3596506Medicaid