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General NPI Number Information
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NPI Number | 1114024445
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Entity Type | Individual
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Provider Name | GREGORY JOE ROBINSON PA
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC 1650 COCHRANE CIR, ATTN: CREDENTIALS OFFICE
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City | FORT CARSON
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State | CO
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Zip | 80913-4604
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Country | US
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Telephone | 719-526-7844
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Fax | 719-526-7984
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Provider Business Mailing Address
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Address Line | 5131 LONESTAR PL
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-3600
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Country | US
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Telephone | 719-591-6029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 764
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License Number State | CO
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