Provider Demographics
NPI:1467885301
Name:ROBINSON, GREGORY C (PA-C, MPAS, THM)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:C
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PA-C, MPAS, THM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14130 CANDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3201
Mailing Address - Country:US
Mailing Address - Phone:719-488-8073
Mailing Address - Fax:
Practice Address - Street 1:3910 S CAREFREE CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3010
Practice Address - Country:US
Practice Address - Phone:719-635-3764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA3624363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant