Provider Demographics
NPI:1477206159
Name:ROBINSON, TONITA D (CPT)
Entity Type:Individual
Prefix:
First Name:TONITA
Middle Name:D
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 WATERTON TRL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-3690
Mailing Address - Country:US
Mailing Address - Phone:678-392-0528
Mailing Address - Fax:
Practice Address - Street 1:1310 WATERTON TRL
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-3690
Practice Address - Country:US
Practice Address - Phone:678-392-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAZ7H8P8W5246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy