Individual
JEFFREY ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
115 COLISEUM XING SPC 58, HAMPTON, VA 23666-5971
(757) 751-6236
(757) 838-1840
Mailing address
102 WINTERVIEW DR, SUFFOLK, VA 23434-7669
(757) 539-0615
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000334
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9204300
—
VA
Enumeration date
09/14/2005
Last updated
08/21/2016
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