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Individual

DR. CHARLES ANDERSON ROBERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 MEDICAL DR STE 707, LAGRANGE, GA 30240-4130
(706) 880-7320
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
(770) 792-5451

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
38947
TN
207X00000X
Orthopaedic Surgery Physician
Primary
87226
GA
207X00000X
Orthopaedic Surgery Physician
MD00042553
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35.086840
OHIO MEDICAL LICENSE
OH
01
38947
TENNESSEE MEDICAL LICENSE
TN
01
MD00042553
WASHINGTON MEDICAL LICENS
WA
Enumeration date
08/28/2006
Last updated
04/22/2021
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