Provider Demographics
NPI:1548311459
Name:ROBERT F TOBIN & ASSOCIATES
Entity type:Organization
Organization Name:ROBERT F TOBIN & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-279-1363
Mailing Address - Street 1:1407 VILLAGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2459
Mailing Address - Country:US
Mailing Address - Phone:816-279-1363
Mailing Address - Fax:816-233-8936
Practice Address - Street 1:900 WOODBURY AVE
Practice Address - Street 2:SUITE 8B
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-7855
Practice Address - Country:US
Practice Address - Phone:712-328-2225
Practice Address - Fax:712-325-4625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-02-26
Deactivation Date:2007-03-20
Deactivation Code:
Reactivation Date:2007-09-20
Provider Licenses
StateLicense IDTaxonomies
IA26658207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1947192Medicaid
IA0492306Medicaid
IACD3323OtherRR MEDICARE
IA0430314Medicaid
IACD3324OtherRR MEDICARE
IAI3063Medicare PIN
IA1947192Medicaid