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Individual

RONALD EARL ROBERTS JR.

Active
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Individual

RONALD EARL ROBERTS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

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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