Healthcare Provider Details

I. General information

NPI: 1780001818
Provider Name (Legal Business Name): SCHON C ROBERTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 07/21/2022
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 LAS VEGAS BLVD N
NELLIS AFB NV
89191-6600
US

IV. Provider business mailing address

360 S LOLA LN
PAHRUMP NV
89048-0884
US

V. Phone/Fax

Practice location:
  • Phone: 702-653-2344
  • Fax:
Mailing address:
  • Phone: 775-751-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number29313
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number17176
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: