Healthcare Provider Details

I. General information

NPI: 1013446384
Provider Name (Legal Business Name): PAUL GORDON HENRY ROBBINS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 INSTITUTE ST
JAMESTOWN NY
14701-6628
US

IV. Provider business mailing address

107 INSTITUTE ST
JAMESTOWN NY
14701-6628
US

V. Phone/Fax

Practice location:
  • Phone: 716-484-4334
  • Fax: 833-974-2031
Mailing address:
  • Phone: 716-484-4334
  • Fax: 833-974-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number00009173
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: