Provider Demographics
NPI:1366782567
Name:ROBINSON, ANDREW ROBERT (D O LLC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ROBERT
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:D O LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 W 9800 S STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4713
Mailing Address - Country:US
Mailing Address - Phone:801-285-8848
Mailing Address - Fax:801-433-5734
Practice Address - Street 1:1868 W 9800 S STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4713
Practice Address - Country:US
Practice Address - Phone:801-285-8848
Practice Address - Fax:801-433-5734
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12754207Q00000X
UT9036325-1204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine