1245453752 NPI number — SCOTT A ROBINSON

Table of content: (NPI 1245453752)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245453752 NPI number — SCOTT A ROBINSON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCOTT A ROBINSON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LAWRENCE WOUND HEALING PHYSICIANS LC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245453752
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1414 W 6TH ST
Provider Second Line Business Mailing Address:
SUTE 200
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66044-1701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-840-0505
Provider Business Mailing Address Fax Number:
785-840-9014

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1112 W 6TH ST
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66044-2215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-840-3126
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
THORNTON
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR PHYSICIANS BILLING OFFICE
Authorized Official Telephone Number:
785-840-0505

Provider Taxonomy Codes

  • Taxonomy code: 207PE0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100151770C , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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