MEDICARE: LESLIE D ROBINSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	45165	CO

General Provider Information

NPI Number	:	1427139088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE D ROBINSON MD

Provider Business Mailing Address
First Line	:	1211 COLORADO AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-4630
Country	:	US
Telephone Number	:	970-255-1514
Fax Number	:	970-255-1514

Provider Business Practice Location Address
First Line	:	1211 COLORADO AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-4630
Country	:	US
Telephone Number	:	970-255-1514
Fax Number	:	970-255-1514

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	02/11/2008

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