Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2328 | AR |
N | 204E00000X | Oral & Maxillofacial Surgeon | C5909 | AR |
NPI | 1386747780 |
---|---|
Provider Name | Dr. Robbie Ray Atkinson |
First Address | Pine Bluff, AR 71603 |
Second Address | Pine Bluff, AR 71603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 24/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
50161 | BCBS (01) | AR |