NPI 1326024597

Jonathan M. Roberts, MD

Practitioner Surgery Physician Jefferson City, MO

Practice location

Address: 1241 W Stadium Blvd, Jefferson City, MO 65109-6023
Phone: (573) 556-7722
Fax: (573) 635-1527
Mailing address: PO Box 104240, Jefferson City, MO 65110-4240

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 106956 (MO)

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Registry record

NPI: 1326024597
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Dec 2005
Record last updated: 7 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.