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Individual

MR. DAVID ALLEN ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
350 E PARKVIEW ST, DYERSBURG, TN 38024-3122
(731) 334-5312
Mailing address
17 CENTRE PLAZA DR, JACKSON, TN 38305-2862
(731) 512-0104
(731) 668-7388

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1501
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1396033379
NPI
TN
05
3665060
TN
05
T10005B
TN
Enumeration date
04/07/2007
Last updated
07/20/2021
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