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Individual
DR. DONALD JACK ROBERTSON
Active
Individual
DR. DONALD JACK ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
F7107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000W0459
—
NM
01
—
122634100
FIRST CARE
—
01
—
131796804
CIDC
—
05
—
131796806
—
TX
01
—
299751
BLACK LUNG
—
01
—
780000444
RAIL ROAD MEDICARE
—
01
—
863277
BLUE CROSS BLUE SHIELD
—
01
—
A004
CHAMPUS
—
01
—
MDF7107
WORK COMP.
—
01
—
Y741
NM BLUE CROSS BLUE SHIELD
NM
Enumeration date
01/05/2007
Last updated
02/23/2017
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