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NPI Code Detail

MEDICARE: JOSEPH MARTIN ROBERTS DO

MEDICARE: JOSEPH MARTIN ROBERTS DO
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 Physician96416GA
2390200000XStudent in an Organized Health Care Education/Training Program

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3G39299AOTHERGAMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396372496
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH MARTIN ROBERTS DO
Provider Business Mailing Address
First Line : PO BOX 1060
Second Line :
City : OAKWOOD
State : GA
Zip : 30566-0018
Country : US
Telephone Number : 770-718-1122
Fax Number :
Provider Business Practice Location Address
First Line : 743 SPRING ST NE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3715
Country : US
Telephone Number : 770-535-3611
Fax Number : 770-535-7092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2020
Last Update Date : 02/04/2026

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Directions to “ JOSEPH MARTIN ROBERTS DO” Practice Location

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