Individual
ROBERT A. ROSSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 W STONE DR STE 2C, KINGSPORT, TN 37660-3365
(423) 378-7679
(423) 378-7679
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2093
(423) 390-3340
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
0101233222
VA
207RP1001X
Pulmonary Disease Physician
Primary
12584
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001676
BLUE CROSS BLUE SHIELD
TN
01
—
006090656
VIRGINIA MEDICAID
VA
01
—
055801
ANTHEM
VA
01
—
100022749
PHP TENN CARE
TN
01
—
1738771
UNITED HEALTHCARE
TN
05
—
3180728
—
TN
01
—
5824025
AETNA
TN
01
—
62134825604
JOHN DEERE HEALTHCARE
TN
01
—
64747850
KENTUCKY MEDICAID
KY
Enumeration date
05/19/2006
Last updated
06/12/2020
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