MEDICARE: MRS. CHERYL LINDA ROBERTSON OTR

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
1	2083X0100X	Occupational Medicine Physician	5Y431	AR

General Provider Information

NPI Number	:	1215924493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL LINDA ROBERTSON OTR

Provider Business Mailing Address
First Line	:	140 CORDOBA CENTER DR
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-4020
Country	:	US
Telephone Number	:	501-922-1686
Fax Number	:	501-922-9735

Provider Business Practice Location Address
First Line	:	140 CORDOBA CENTER DR
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-4020
Country	:	US
Telephone Number	:	501-922-1686
Fax Number	:	501-922-9735

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	07/08/2007

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