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General NPI Number Information
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NPI Number | 1568545143
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Entity Type | Organization
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Legal Business Name | KENNETH C ROBERTS DO APMC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 95 E FAIRWAY DRIVE
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City | COVINGTON
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State | LA
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Zip | 70433
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Country | US
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Telephone | 985-966-3757
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 850299
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City | YUKON
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State | KS
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Zip | 73085-0299
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Country | US
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Telephone | 405-324-7332
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH C ROBERTS
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Credential | DO
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Telephone | 405-324-7332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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