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Individual

DR. BOBBY JACK ROBERTSON JR.

Active
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Individual

DR. BOBBY JACK ROBERTSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2002019220
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168022
BCBS
—
01
—
397682
HEALTHLINK
—
01
—
5283529
AETNA
—
01
—
648230
UNITED HEALTH CARE
—
Enumeration date
08/17/2006
Last updated
01/27/2012
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