Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 054335 | GA |
NPI | 1225193576 |
---|---|
Provider Name | Christopher Lee Robinson |
First Address | Rome, GA 30165-1625 |
Second Address | Rome, GA 30165-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 30/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
838532259A | (05) | GA |
838532259B | (05) | GA |
I08409 | (02) |