Provider Demographics
NPI:1104346493
Name:ROBINSON, JOSEPH GARY
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:GARY
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 POLARIS DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37034-2461
Mailing Address - Country:US
Mailing Address - Phone:615-804-4813
Mailing Address - Fax:
Practice Address - Street 1:4506 POLARIS DR
Practice Address - Street 2:
Practice Address - City:CHAPELHILL
Practice Address - State:TN
Practice Address - Zip Code:37034-2461
Practice Address - Country:US
Practice Address - Phone:615-804-4813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant