Provider Demographics
NPI:1134203755
Name:ROBINSON, WILLIAM P JR (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:P
Last Name:ROBINSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:815 E 5TH STREET
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002
Mailing Address - Country:US
Mailing Address - Phone:618-463-0561
Mailing Address - Fax:618-465-9281
Practice Address - Street 1:815 E 5TH STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002
Practice Address - Country:US
Practice Address - Phone:618-463-0561
Practice Address - Fax:618-465-9281
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL715630Medicare ID - Type Unspecified
I93424Medicare UPIN