Provider Demographics
NPI:1427102813
Name:ROBINETTE, DANNY RAY (MD)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:RAY
Last Name:ROBINETTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 PARKS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-2111
Mailing Address - Country:US
Mailing Address - Phone:907-479-8511
Mailing Address - Fax:
Practice Address - Street 1:1275 SADLER WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3175
Practice Address - Country:US
Practice Address - Phone:907-451-6142
Practice Address - Fax:907-451-6284
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA 2929208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2929Medicaid
AKF46707Medicare UPIN
AKMD2929Medicaid