Provider Demographics
NPI:1235136896
Name:LEIGHT, ROBIN L (MD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:LEIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8715
Mailing Address - Country:US
Mailing Address - Phone:802-888-8100
Mailing Address - Fax:802-888-8279
Practice Address - Street 1:530 WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8715
Practice Address - Country:US
Practice Address - Phone:802-888-8100
Practice Address - Fax:802-888-8279
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0008483207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN0354Medicaid
VT15168OtherMVP PROVIDER ID NUMBER
VT10002699OtherCDPHP PROVIDER NUMBER
VT216-18523OtherVT BC/BS PROVIDER NUMBER
VT216-5217OtherVT BC/BS GROUP ID NUMBER
VTVN0354Medicare ID - Type UnspecifiedMCR INDIVIDUAL PROVIDER N
VT10002699OtherCDPHP PROVIDER NUMBER