Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 10380547-9922 | UT |
N | 213EG0000X | General Practice | 10380547-9922 | UT |
Y | 1223G0001X | General Practice | 7434 | OK |
Y | 213EG0000X | General Practice | 7434 | OK |
NPI | 1003335308 |
---|---|
Provider Name | Dr. Scott Carl Robinson |
First Address | Catoosa, OK 74015-1520 |
Second Address | Catoosa, OK 74015-1520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2017 |
Last Update Date | 17/05/2021 |