Individual
JEFFERY PAUL ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1460 G ST, SPRINGFIELD, OR 97477-4112
(541) 726-4580
(541) 726-3166
Mailing address
1460 G ST, SPRINGFIELD, OR 97477-4112
(541) 726-4580
(541) 726-3166
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
PA00684
OR
363A00000X
Physician Assistant
PA00684
OR
Other
Enumeration date
04/24/2007
Last updated
07/29/2008
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