Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 74999 | GA |
NPI | 1639460777 |
---|---|
Provider Name | Dr. Philip Kurt Robb JR. |
First Address | Alpharetta, GA 30005 |
Second Address | Little Rock, AR 72205-7101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2011 |
Last Update Date | 01/05/2017 |