Individual
BRIAN TODD ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
36 MEDICAL PLZ STE 1A, HANOVER, IN 47243-9481
(812) 866-3301
(812) 866-3327
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02005964A
IN
207R00000X
Internal Medicine Physician
R4511
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300037404
—
IN
05
—
7100544410
—
KY
Enumeration date
05/02/2017
Last updated
10/09/2025
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