Individual
RUSSELL SCOTT ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1108 W INDIAN SCHOOL RD, PHOENIX, AZ 85013-3107
(602) 773-5600
(602) 773-5601
Mailing address
1108 W INDIAN SCHOOL RD, STE B, PHOENIX, AZ 85013-3107
(602) 773-5600
(602) 773-5601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5788
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
975247
—
AZ
01
—
Z173607
PTAN
AZ
Enumeration date
09/12/2014
Last updated
10/01/2015
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