Individual
DR. JONATHAN JERARD ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2240 W THOMAS ST, HAMMOND, LA 70401-2828
(985) 348-6139
(877) 870-5503
Mailing address
2240 W THOMAS ST, HAMMOND, LA 70401-2828
(985) 348-6139
(877) 870-5503
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
021278
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021278
M.D. LICENSE
LA
01
—
1930628
INTERNAL MEDICINE
LA
05
—
1930628
—
LA
01
—
721511296
EMPLOYER TAX ID
—
Enumeration date
01/02/2007
Last updated
12/16/2021
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