Provider Demographics
NPI:1306959242
Name:ROBINSON, RAYMOND KENT JR (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:KENT
Last Name:ROBINSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE B215
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3706
Mailing Address - Country:US
Mailing Address - Phone:251-639-0001
Mailing Address - Fax:251-639-3194
Practice Address - Street 1:6701 AIRPORT BLVD STE B215
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3706
Practice Address - Country:US
Practice Address - Phone:251-639-0001
Practice Address - Fax:251-639-3194
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000104132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528401660Medicaid
AL12952Medicaid
C74512Medicare UPIN
000012952Medicare ID - Type Unspecified