Basic Information
| Provider Information | |||||||||
| NPI: | 1174938237 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ROBBINS | ||||||||
| FirstName: | JEREMY | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF ANESTHESIOLOGY | ||||||||
| Address2: | ONE HOSPITAL DRIVE, DC005.00 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652120001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738822568 | ||||||||
| FaxNumber: | 5738822226 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 E BOULDER ST STE 2508 | ||||||||
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| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809095533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193656999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2014 | ||||||||
| LastUpdateDate: | 06/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 2014021211 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | DR.0060105 | CO | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.