Basic Information
Provider Information
NPI: 1518195239
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBINSON
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18444 N 25TH AVE
Address2: STE 310
City: PHOENIX
State: AZ
PostalCode: 850231266
CountryCode: US
TelephoneNumber: 6235375600
FaxNumber: 8669392673
Practice Location
Address1: 3420 S MERCY RD
Address2: STE 200
City: GILBERT
State: AZ
PostalCode: 852970419
CountryCode: US
TelephoneNumber: 6235375600
FaxNumber: 8669392673
Other Information
ProviderEnumerationDate: 07/01/2009
LastUpdateDate: 04/23/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X005588AZN Allopathic & Osteopathic PhysiciansFamily Medicine 
207QS0010X005588AZY Allopathic & Osteopathic PhysiciansFamily MedicineSports Medicine

ID Information
IDTypeStateIssuerDescription
555083000301AZMEDICARE NSC PEORIAOTHER
555083000101AZMEDICARE NSC SCWOTHER
80996205AZ MEDICAID
00558801AZAZ MEDICAL LICENSEOTHER
555083000701AZMEDICARE NSC DVOTHER
555083001001AZMEDICARE NSC GILBERTOTHER


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