Individual
JOHN WARREN ROBERTSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 GOPHER DR, TOMAH, WI 54660-4513
(608) 372-2181
Mailing address
501 GOPHER DR, TOMAH, WI 54660-4513
(608) 372-2181
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD044947E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001304593007
—
PA
Enumeration date
06/29/2006
Last updated
01/04/2021
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