MEDICARE: DR. SANGEETA JAIN-ROBERTS 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
1	207R00000X	Internal Medicine Physician	107129	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110104028	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CC7852	OTHER	MO	RR GROUP
2	12924	OTHER	MO	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235117698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANGEETA JAIN-ROBERTS M.D.

Provider Business Mailing Address
First Line	:	1619 PADDLEWHEEL CIR
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-1293
Country	:	US
Telephone Number	:	573-761-0777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 PADDLEWHEEL CIR
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-1293
Country	:	US
Telephone Number	:	573-761-0777
Fax Number	:

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	11/27/2012

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Directions to “ DR. SANGEETA JAIN-ROBERTS M.D.” Practice Location

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