Individual
RONALD EARL ROBERTS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
202 BEVINS LN, GEORGETOWN, KY 40324-6178
(859) 323-9333
Mailing address
2195 HARRODSBURG RD STE 125, LEXINGTON, KY 40504-3504
(859) 323-6793
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32142
KY
208000000X
Pediatrics Physician
32142
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110244643
RR MEDICARE PIN
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64321425
—
KY
01
—
CB5773
RR MEDICARE GROUP
KY
Enumeration date
07/18/2006
Last updated
09/27/2019
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