Provider Demographics
NPI:1871692517
Name:ROBINSON, ANTHONY J (CSA)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:J
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:145 FOREST HALL LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4025
Mailing Address - Country:US
Mailing Address - Phone:678-662-8792
Mailing Address - Fax:770-629-2380
Practice Address - Street 1:145 FOREST HALL LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4025
Practice Address - Country:US
Practice Address - Phone:678-662-8792
Practice Address - Fax:770-629-2380
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2507208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty