Provider Demographics
NPI:1588695266
Name:NORTHROP, ROBERT C (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:NORTHROP
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 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-952-2111
Mailing Address - Fax:423-282-1657
Practice Address - Street 1:16000 JOHNSTON MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7664
Practice Address - Country:US
Practice Address - Phone:276-258-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36287208600000X, 208600000X, 2086S0127X, 2086S0129X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007313080OtherVIRGINIA MEDICAID
TN4043623OtherBCBS TENNESSEE
VI245736OtherANTHEM BCBS VIRGINIA
TN3875209Medicaid
7443396OtherAETNA
TNQ000959Medicaid
TN020052848OtherRAILROAD MEDICARE
VI245736OtherANTHEM BCBS VIRGINIA
TN3875209Medicaid
TN4043623OtherBCBS TENNESSEE