Provider Demographics
NPI:1639523608
Name:ROBBINS, GORDON TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:TODD
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 CALIBRE XING NW STE 1200
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-4104
Mailing Address - Country:US
Mailing Address - Phone:678-631-4600
Mailing Address - Fax:678-631-4601
Practice Address - Street 1:4450 CALIBRE XING NW STE 1200
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4104
Practice Address - Country:US
Practice Address - Phone:678-631-4600
Practice Address - Fax:678-631-4601
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA95369207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program