Individual
DR. KENNETH R ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1129 HALE RD, MEMPHIS, TN 38116-6373
(901) 396-0390
(901) 396-3728
Mailing address
1129 HALE RD, MEMPHIS, TN 38116-6373
(901) 396-0390
(901) 396-3728
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD13478
MS
208000000X
Pediatrics Physician
Primary
MD23567
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q014826
—
TN
Enumeration date
09/29/2005
Last updated
07/13/2016
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