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NPI Code Detail

MEDICARE: KARYN F. ROBERTSON PA

MEDICARE: KARYN F. ROBERTSON PA
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
1363A00000XPhysician Assistant002551NY
2363AS0400XSurgical Physician Assistant002551NY
3363AS0400XSurgical Physician Assistant1339AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871590661
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARYN F. ROBERTSON PA
Provider Business Mailing Address
First Line : 7165 E UNIVERSITY DR STE 187
Second Line :
City : MESA
State : AZ
Zip : 85207-6415
Country : US
Telephone Number : 480-668-5000
Fax Number : 480-428-8593
Provider Business Practice Location Address
First Line : 7165 E UNIVERSITY DR STE 183
Second Line :
City : MESA
State : AZ
Zip : 85207-6415
Country : US
Telephone Number : 480-668-5000
Fax Number : 480-668-5065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 03/08/2022

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Directions to “ KARYN F. ROBERTSON PA” Practice Location

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