Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 5953 | KY |
NPI | 1063509743 |
---|---|
Provider Name | Dr. Micheal Link Robinson |
First Address | Edgewood, KY 41017-5401 |
Second Address | Edgewood, KY 41017-5401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T83776 | (02) | KY |