Provider Demographics
NPI:1699734764
Name:ROBINSON, RICHARD RANDAL (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:RANDAL
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1455 S. DOUGLAS
Mailing Address - Street 2:SUITE D
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130
Mailing Address - Country:US
Mailing Address - Phone:405-733-4545
Mailing Address - Fax:405-733-2758
Practice Address - Street 1:1455 S. DOUGLAS
Practice Address - Street 2:SUITE D
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130
Practice Address - Country:US
Practice Address - Phone:405-733-4545
Practice Address - Fax:405-733-2758
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11333207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D35210Medicare UPIN