Individual
ROBERT BOTKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
272 MEDICAL LOOP, SUITE C, ROSEBURG, OR 97471
(541) 440-3532
(541) 440-3554
Mailing address
272 MEDICAL LOOP, SUITE E, ROSEBURG, OR 97471
(541) 440-3532
(541) 440-3554
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500671880
—
OR
Enumeration date
05/19/2014
Last updated
10/23/2015
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