Provider Demographics
NPI:1972535631
Name:ROBINSON, LEROY F (MD)
Entity type:Individual
Prefix:
First Name:LEROY
Middle Name:F
Last Name:ROBINSON
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 1:701 MEDICAL PARK DR
Mailing Address - Street 2:STE 202
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4777
Mailing Address - Country:US
Mailing Address - Phone:843-339-9222
Mailing Address - Fax:843-339-2830
Practice Address - Street 1:701 MEDICAL PARK DR
Practice Address - Street 2:SUITE 202
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4777
Practice Address - Country:US
Practice Address - Phone:843-339-9222
Practice Address - Fax:843-339-2830
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15491207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCE94165Medicare UPIN