Provider Demographics
NPI:1659465581
Name:ROBINSON, JEFFREY L G (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L G
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16700 N THOMPSON PEAK PKWY
Mailing Address - Street 2:STE 260
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2388
Mailing Address - Country:US
Mailing Address - Phone:480-991-5555
Mailing Address - Fax:480-948-8295
Practice Address - Street 1:16700 N THOMPSON PEAK PKWY STE 260
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2388
Practice Address - Country:US
Practice Address - Phone:480-991-5555
Practice Address - Fax:480-948-8295
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ00944630OtherBCBS AZ NUMBER
AZZ80718Medicare PIN