Individual
JOHN HAFFELE ROBERTS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4230 HAMILTON BLVD, SIOUX CITY, IA 51104-1137
(712) 239-4300
(712) 239-2866
Mailing address
27 QUAIL CT, SIOUX CITY, IA 51104-1400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17892
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1084863
—
IA
05
—
75305796312
—
NE
05
—
7789082
—
SD
Enumeration date
02/22/2006
Last updated
07/08/2007
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