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NPI Code Detail

MEDICARE: DR. CHRISS B ROBERTS D.O.

MEDICARE:  DR. CHRISS B ROBERTS  D.O.
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
1207Q00000XFamily Medicine Physician1669OK

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 : 1710979315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISS B ROBERTS D.O.
Provider Business Mailing Address
First Line : PO BOX 870
Second Line : 1306 S.W. THIRD
City : WAGONER
State : OK
Zip : 74477-0870
Country : US
Telephone Number : 918-485-4444
Fax Number : 918-485-7407
Provider Business Practice Location Address
First Line : 1306 SW 3RD ST
Second Line :
City : WAGONER
State : OK
Zip : 74467-5518
Country : US
Telephone Number : 918-485-4444
Fax Number : 918-485-7407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 04/24/2008

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Directions to “ DR. CHRISS B ROBERTS D.O.” Practice Location

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