Individual
JOHN WILLIAM ROBERTS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 382-7120
Mailing address
420 HANSELL SEARS RD, DOUGLAS, GA 31535-5720
(912) 592-0765
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN230702
GA
367500000X
Certified Registered Nurse Anesthetist
090060-23
NH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN230702
GA
Other
Enumeration date
01/03/2018
Last updated
01/17/2023
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