Provider Demographics
NPI:1629330683
Name:RANDOLPH C ROBINSON MD
Entity Type:Organization
Organization Name:RANDOLPH C ROBINSON MD
Other - Org Name:ROBINSON COSMETIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:303-792-2828
Mailing Address - Street 1:10375 PARK MEADOWS DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-6735
Mailing Address - Country:US
Mailing Address - Phone:303-792-2828
Mailing Address - Fax:303-792-3328
Practice Address - Street 1:10375 PARK MEADOWS DR
Practice Address - Street 2:SUITE 150
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6735
Practice Address - Country:US
Practice Address - Phone:303-792-2828
Practice Address - Fax:303-792-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6757122300000X, 1223S0112X
CO31972204E00000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty