Individual provider · Type 1 NPI
Destiny D. Robertson, PA-C
Medical Physician Assistant · Goldsby, OK
NPI number
1629645015
Active
Practice location
117 Cotton Field Rd Ste C
Goldsby, OK 73093-5061
Mailing address
PO Box 1330
Norman, OK 73070-1330
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 4596 (OK) |
Medical Physician Assistant: Definition to come...
About NPI 1629645015
Destiny D. Robertson, PA-C's National Provider Identifier is 1629645015, issued on Jun 5, 2021. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Goldsby, OK. The record was last updated on Feb 9, 2026.