Individual
MARCUS CARROLL ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
(229) 391-4100
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 353-3450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35986
GA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
035986
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000508791B
—
GA
01
—
CL2838
MEDICARE RAILROAD
—
Enumeration date
04/25/2006
Last updated
03/08/2021
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