Omotola, Robinson J

Omotola, Robinson J is an individual health care provider with primary practice located at 400 N Pleasant Ave , Centralia IL 62801-3056. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Omotola, Robinson J can be contacted via phone (618) 436-5461.

Contact Information

Primary practice address
400 N Pleasant Ave Centralia IL 62801-3056
Phone: (618) 436-5461
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP2030632 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X Illinois

Profile Details

NPI number 1760593131
LBN Legal business name Omotola, Robinson J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760593131 NPPES
Florida Other G2971 BLUE CROSS BLUE SHIELD

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