Provider Demographics
NPI:1528161015
Name:ROBESON, JAMES A (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:ROBESON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5041 N 12TH AVE
Mailing Address - Street 2:COVENANT HOSPICE
Mailing Address - City:PENSCOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504
Mailing Address - Country:US
Mailing Address - Phone:850-433-2155
Mailing Address - Fax:850-202-0600
Practice Address - Street 1:207 W ADAMS STREET
Practice Address - Street 2:COVENANT HOSPICE
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303
Practice Address - Country:US
Practice Address - Phone:334-794-7847
Practice Address - Fax:334-794-2453
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
ALAL5134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F57471Medicare UPIN