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NPI Code Detail

MEDICARE: LEROY ROBERTS JR. M.D.

MEDICARE: LEROY ROBERTS JR. M.D.
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
12085N0700XNeuroradiology Physician30989NC
22085R0202XDiagnostic Radiology Physician30989NC

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 : 1073518254
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEROY ROBERTS JR. M.D.
Provider Business Mailing Address
First Line : 3186 VILLAGE DR 201
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3979
Country : US
Telephone Number : 910-486-5700
Fax Number : 910-486-5950
Provider Business Practice Location Address
First Line : 3186 VILLAGE DR 201
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3979
Country : US
Telephone Number : 910-486-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 08/18/2015

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Directions to “ LEROY ROBERTS JR. M.D.” Practice Location

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