Doctor Name: | DAN EARL ROBINSON |
NPI Number: | 1013139898 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | P-204 |
Business Practice Address: | 98 Poplar St Blackfoot, ID - 832211758 |
Business Phone Number: | 2086900394 |
Business Fax Number: | |
Mailing Address: | 98 Poplar St, BLACKFOOT |
State: | ID |
Postal Code: | 832211758 |
Phone Number: | 2086903094 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 02/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | P-204 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |