Individual
JOHN LEE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
(502) 852-8556
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5817
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
22476
KY
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
22476
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100329700
—
IN
01
—
22476
STATE LICENSE
KY
05
—
6422476900
—
KY
Enumeration date
12/01/2005
Last updated
05/27/2022
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