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General NPI Number Information
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NPI Number | 1457416802
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Entity Type | Individual
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Provider Name | DR. MARTIN CLIFTON ROBERTSON
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1201 E 35TH ST
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City | TEXARKANA
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State | AR
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Zip | 71854-2746
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Country | US
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Telephone | 870-774-3666
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Fax | 870-772-8062
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Provider Business Mailing Address
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Address Line | 1201 E 35TH ST
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City | TEXARKANA
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State | AR
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Zip | 71854-2746
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Country | US
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Telephone | 870-774-3666
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Fax | 870-772-8062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 05524
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License Number State | AR
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