Provider Demographics
NPI:1386703767
Name:ROBINSON, DAVID M (AUD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N 200 W
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84318-4040
Mailing Address - Country:US
Mailing Address - Phone:435-563-3484
Mailing Address - Fax:435-753-7691
Practice Address - Street 1:575 E 1400 N STE 140
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2456
Practice Address - Country:US
Practice Address - Phone:435-753-7171
Practice Address - Fax:435-753-7691
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT03244864101237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1386703767OtherMOLINA
UT70962OtherPEHP
UT005742001OtherPIN #000057420
UT1386703767OtherHEALTH U
UT1386703767Medicaid
UT210420OtherALTIUS
UT70962OtherCHIP
UT215622869069OtherMOLINA
87050328684405A003OtherTRI-WEST
UT001082371003OtherUHC
UT001082371007OtherUHC
UT03244864101001OtherBCBS
UT241780801OtherFED WORKERS COMP
87050328684341A002OtherTRI-WEST
UT1386703767OtherMAILHANDLERS
UT80598OtherCHIP
UT001082371003OtherUNITED HEALTHCARE
870503286684302A003OtherTRI-WEST
00002080315OtherUNITED HEALTHCARE
UT210421OtherALTIUS
UT80598OtherPEHP
UT03244864101001OtherBCBS
UT80598OtherPEHP
UT000064613Medicare PIN