1952681595 NPI number — DR. GARRY PAUL ROBBINS JR. PHARMD

Table of content: DR. TERESA ANN WISE OD (NPI 1114076288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952681595 NPI number — DR. GARRY PAUL ROBBINS JR. PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBBINS
Provider First Name:
GARRY
Provider Middle Name:
PAUL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1952681595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 W WILL ROGERS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAREMORE
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74017-6824
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-343-7451
Provider Business Mailing Address Fax Number:
918-341-6278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 W WILL ROGERS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAREMORE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74017-6824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-343-7451
Provider Business Practice Location Address Fax Number:
918-341-6278
Provider Enumeration Date:
08/26/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  14303 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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