Individual
MR. STANLEY L. ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
510 MELTON HILL DR, CLINTON, TN 37716-7107
(865) 457-4027
Mailing address
510 MELTON HILL DR, CLINTON, TN 37716-7107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MR0575754
TN
363A00000X
Physician Assistant
PA00015
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4069076
BLUE CROSS
TN
Enumeration date
06/06/2006
Last updated
05/03/2013
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