Provider Demographics
NPI:1972961597
Name:ROBSON, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:ROBSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9463 HOLLY RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2557
Mailing Address - Country:US
Mailing Address - Phone:810-599-9321
Mailing Address - Fax:
Practice Address - Street 1:9463 HOLLY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2557
Practice Address - Country:US
Practice Address - Phone:810-599-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic