Individual
DR. KEVIN G ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
713 W MAIN ST, FREDERICKTOWN, MO 63645-1113
(573) 783-3188
(573) 783-3314
Mailing address
PO BOX 189, FREDERICKTOWN, MO 63645-0189
(573) 783-3188
(573) 783-3314
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
004431
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000013947
MEDICARE GROUP
MO
01
—
0497085
HEALTHLINK ID #
MO
01
—
106834
HEALTHLINK ID #
MO
01
—
12362
BLUE CROSS ID #
MO
01
—
4407100
UNITED HEALTHCARE ID #
MO
05
—
752824805
—
MO
Enumeration date
06/15/2006
Last updated
10/06/2010
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