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Individual

DR. THEODORE J. ROBNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
510 SW RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 472-7040
Mailing address
PO BOX 8509, MEDFORD, OR 97501-5009
(541) 772-0023
(541) 472-7043

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
A75314
CA
2085R0001X
Radiation Oncology Physician
Primary
MD28266
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD28266
OREGON STATE MEDICAL LICENSE
OR
Enumeration date
06/28/2005
Last updated
06/25/2009
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