Provider Demographics
NPI:1861418493
Name:TOWNSEND, ROBERT T (CRNA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5227
Mailing Address - Fax:740-441-8058
Practice Address - Street 1:272 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9031
Practice Address - Country:US
Practice Address - Phone:407-797-5407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH257529367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0066748000Medicaid
000000006616OtherANTHEM BCBS
001714082OtherMOUNTAIN STATE BCBS
OH0128374OtherMOLINA MEDICAID #
OH0128374Medicaid
OH430023794OtherRR MEDICARE
000000006616OtherANTHEM BCBS
OH0128374Medicaid