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General NPI Number Information
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NPI Number | 1629103635
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Entity Type | Organization
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Legal Business Name | J. GREGORY ROBERTS MD RVT
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 223 ANDREW DR
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City | ONEIDA
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State | TN
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Zip | 37841
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Country | US
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Telephone | 865-218-6244
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Fax | 865-218-6245
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Provider Business Mailing Address
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Address Line | 1728 FALCON POINTE DR
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City | KNOXVILLE
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State | TN
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Zip | 37922-6397
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Country | US
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Telephone | 865-742-3063
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Fax | 865-218-6244
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JAMES GREGORY ROBERTS
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Credential | MD RVT
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Telephone | 865-218-6244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 37706
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License Number State | TN
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