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NPI Code Detail

MEDICARE: JUSTIN KURT ROBERTS M.D.

MEDICARE: JUSTIN KURT 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
1208600000XSurgery PhysicianM0244TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2159582101OTHERTXFIRSTCARE
38AN710OTHERTXBCBS

General Provider Information

NPI Number : 1669434106
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN KURT ROBERTS M.D.
Provider Business Mailing Address
First Line : 320 ALPENGLOW LN
Second Line :
City : LIVINGSTON
State : MT
Zip : 59047-8506
Country : US
Telephone Number : 406-222-0800
Fax Number : 406-222-7606
Provider Business Practice Location Address
First Line : 320 ALPENGLOW LN
Second Line :
City : LIVINGSTON
State : MT
Zip : 59047-8506
Country : US
Telephone Number : 406-222-0800
Fax Number : 406-222-7606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 07/27/2020

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