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NPI Code Detail

MEDICARE: DR. GREGORY ROBERT ROBINSON PH.D.

MEDICARE: DR. GREGORY ROBERT ROBINSON PH.D.
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
1103T00000XPsychologist01395MO

General Provider Information

NPI Number : 1598829558
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY ROBERT ROBINSON PH.D.
Provider Business Mailing Address
First Line : 641 N NEW BALLAS RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-6713
Country : US
Telephone Number : 314-872-3345
Fax Number : 314-872-3180
Provider Business Practice Location Address
First Line : 641 N NEW BALLAS RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-6713
Country : US
Telephone Number : 314-872-3345
Fax Number : 314-872-3180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 07/08/2007

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