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NPI Code Detail

MEDICARE: DR. DONALD CHARLES ROBERTSON DO

MEDICARE: DR. DONALD CHARLES ROBERTSON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician2007005536MO

General Provider Information

NPI Number : 1538297593
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD CHARLES ROBERTSON DO
Provider Business Mailing Address
First Line : 1771 CURTIS DR
Second Line : #200
City : IUKA
State : MS
Zip : 38852-1001
Country : US
Telephone Number : 662-423-6014
Fax Number : 662-423-2972
Provider Business Practice Location Address
First Line : 1771 CURTIS DR
Second Line : #200
City : IUKA
State : MS
Zip : 38852-1001
Country : US
Telephone Number : 662-423-6014
Fax Number : 662-423-2972
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 02/26/2011

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Directions to “ DR. DONALD CHARLES ROBERTSON DO” Practice Location

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