Provider Demographics
NPI:1164912044
Name:ROBINSON, JOEL (SA-C)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 SUMMIT PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5334
Mailing Address - Country:US
Mailing Address - Phone:770-256-7795
Mailing Address - Fax:
Practice Address - Street 1:3210 SUMMIT PLACE DR
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-5334
Practice Address - Country:US
Practice Address - Phone:770-256-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant