Individual
JON D ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-3573
(573) 445-7285
Mailing address
1123 WILKES BLVD, SUITE 120, COLUMBIA, MO 65201
(573) 445-7272
(573) 445-7285
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
110556
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203932207
—
MO
Enumeration date
10/13/2005
Last updated
07/13/2010
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