Provider Demographics
NPI:1386945194
Name:DONALD H ROBBINS JR DO PC
Entity type:Organization
Organization Name:DONALD H ROBBINS JR DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:989-635-2643
Mailing Address - Street 1:2750 MAIN ST
Mailing Address - Street 2:STE 4
Mailing Address - City:MARLETTE
Mailing Address - State:MI
Mailing Address - Zip Code:48453-1100
Mailing Address - Country:US
Mailing Address - Phone:989-635-2643
Mailing Address - Fax:989-635-8282
Practice Address - Street 1:2750 MAIN ST
Practice Address - Street 2:STE 4
Practice Address - City:MARLETTE
Practice Address - State:MI
Practice Address - Zip Code:48453-1100
Practice Address - Country:US
Practice Address - Phone:989-635-2643
Practice Address - Fax:989-635-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI008806208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1755440Medicaid
MI1755440Medicaid