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NPI Code Detail

MEDICARE: DR. CHRISTOPHER LEE ROBERTSON D.O.

MEDICARE: DR. CHRISTOPHER LEE ROBERTSON D.O.
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
1208000000XPediatrics PhysicianE-7476AR
2208000000XPediatrics Physician5336OK

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 : 1033353388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER LEE ROBERTSON D.O.
Provider Business Mailing Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-660-3400
Fax Number : 918-660-3410
Provider Business Practice Location Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-660-3400
Fax Number : 918-660-3410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2009
Last Update Date : 06/13/2013

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