Individual
DR. GARY ALAN ROBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
3550 HIGHWAY 468 WEST, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8301
Mailing address
1855 LAKELAND DR, SUITE P-231, JACKSON, MS 39216-4913
(601) 906-4479
(601) 366-3256
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
15474
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008124779
—
MS
01
—
260002937
MEDICARE PTAN
MN
Enumeration date
12/22/2006
Last updated
09/06/2023
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