Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 32119 | AZ |
NPI | 1619181302 |
---|---|
Provider Name | Dr. Ben Carter Robinson |
First Address | Bullhead City, AZ 86442-5962 |
Second Address | Las Vegas, NV 89191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 18/09/2015 |