Provider Demographics
NPI:1285083717
Name:ROBINSON, COREY (PA-C)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7675 WOLF RIVER CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1747
Mailing Address - Country:US
Mailing Address - Phone:901-737-3021
Mailing Address - Fax:901-737-6063
Practice Address - Street 1:7675 WOLF RIVER CIR STE 202
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138
Practice Address - Country:US
Practice Address - Phone:901-737-3021
Practice Address - Fax:901-737-6063
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2841363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical