Individual
JOHN M ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
170 BEECH ST, SUITE 1, HARROGATE, TN 37752-8251
(423) 869-3684
(423) 869-5460
Mailing address
170 BEECH ST STE 1, P.O. BOX 750, HARROGATE, TN 37752-8251
(423) 869-3684
(423) 869-5460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
47585
TN
207Q00000X
Family Medicine Physician
Primary
53166
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47585
LICENSE
TN
Enumeration date
07/15/2008
Last updated
12/20/2016
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