Provider Demographics
NPI:1174594907
Name:BILLINGS, ROBERT EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EUGENE
Last Name:BILLINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 6TH ST
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-1201
Mailing Address - Country:US
Mailing Address - Phone:253-582-3426
Mailing Address - Fax:253-582-8060
Practice Address - Street 1:322 S BIRCH ST
Practice Address - Street 2:
Practice Address - City:MCCLEARY
Practice Address - State:WA
Practice Address - Zip Code:98557-9522
Practice Address - Country:US
Practice Address - Phone:360-495-3244
Practice Address - Fax:360-495-4566
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00013280146D00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1143700Medicaid
WAE71824Medicare UPIN
WAGAB37374Medicare ID - Type Unspecified
WAG8903688Medicare PIN
WA1143700Medicaid