Healthcare Provider Details
I. General information
NPI: 1972682177
Provider Name (Legal Business Name): SYLVIA MARIA ROBLES-MEYERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4665 MAIN ST SUITE 4
JASPER TN
37347
US
IV. Provider business mailing address
4665 MAIN ST SUITE 4
JASPER TN
37347
US
V. Phone/Fax
- Phone: 423-942-1993
- Fax: 423-942-6694
- Phone: 423-942-1993
- Fax: 423-942-6694
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD35834 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: