Provider Demographics
NPI:1972615045
Name:ROBBINS, DONALD L (OD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:L
Other - Last Name:ROBBINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-0011
Mailing Address - Country:US
Mailing Address - Phone:706-865-5329
Mailing Address - Fax:706-219-2124
Practice Address - Street 1:514 WEST KYTLE STREET
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528
Practice Address - Country:US
Practice Address - Phone:706-865-5329
Practice Address - Fax:706-219-2124
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001058152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00357145AMedicaid
GA0388300001Medicare NSC
GA00357145AMedicaid