Individual
KEVIN CLARK ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2001 PEACHTREE RD NE STE 705, ATLANTA, GA 30309-1476
(404) 355-0743
(855) 273-3558
Mailing address
2001 PEACHTREE RD NE STE 705, ATLANTA, GA 30309-1476
(404) 355-0743
(855) 273-3558
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10158
GA
363A00000X
Physician Assistant
PA17110
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17110
MEDICAL LICENSE
CA
Enumeration date
04/30/2007
Last updated
07/21/2026
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