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GERALD R ROBERTS MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1902874324

Individual Registrant:
 GERALD R ROBERTS MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1738 CLEVELAND AVENUE  CASTLEBERRY, AL 36432 US
Tel: 251-966-5440  Fax: --

Contact information for business:
1738 CLEVELAND AVENUE  CASTLEBERRY, AL 36432 US
Tel: --  Fax: --

Registration Information:
NPI: 1902874324
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
AL3820

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
RAILROAD MEDICARE08004825301
MEDICARE GROUP NUMBERG402AL01
MEDICAL LICENSE3820AL01
631705003AL05




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