Individual
MR. LON EDWARD ROBERTS JR.
Active
Individual
MR. LON EDWARD ROBERTS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19053
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000229189
ANTHEM
KY
01
—
10805823
CAQH
KY
05
—
64190531
—
KY
Enumeration date
11/18/2005
Last updated
05/14/2013
Update your record
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