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NPI Code Detail

MEDICARE: DR. ROBERT MICHAEL ROANEY MD

MEDICARE: DR. ROBERT MICHAEL ROANEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA19696CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023173622
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT MICHAEL ROANEY MD
Provider Business Mailing Address
First Line : 305 EAST CENTER AVE.
Second Line :
City : VISALIA
State : CA
Zip : 93291-6331
Country : US
Telephone Number : 559-737-4700
Fax Number : 559-737-4782
Provider Business Practice Location Address
First Line : 201 EAST LAKEVIEW AVENUE
Second Line :
City : WOODLAKE
State : CA
Zip : 93286-1301
Country : US
Telephone Number : 559-564-0100
Fax Number : 559-564-8723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/25/2006
Last Update Date : 06/26/2012

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