JUSTIN W. ROBERTS (NPI# 1619057064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619057064 |
Entity Type | Individual |
Full Name | JUSTIN W. ROBERTS |
Credential | DO |
Practice Address |
501 West Pine Street Farmington MO 63640 |
Mailing Address |
501 West Pine Street Farmington MO 63640-1439 |
Practice Telephone | 5737568888 |
Practice Fax Number | 8662915617 |
Mailing Telephone | 5737568888 |
Mailing Fax Number | 5737019547 |
Enumeration Date | 2006-10-17 |
Last Update Date | 2017-09-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
2004027799 | MO | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962953158 | Justin Roberts | Nurse Practitioner | 333 S 38th St Ste E, Muskogee, OK 74401-4937 | 2016-10-22 |
1073880746 | Justin L Roberts | Dentist | 807 Spring Forest Road, Raleigh, NC 27609 | 2011-11-24 |
1407481146 | Justin Hugh Roberts | Physician Assistant | 901 18th St E, Tifton, GA 31794-3648 | 2020-03-03 |
1063045425 | Justin Ryan Roberts | Pharmacist | 2950 S Newburgh Rd, Wayne, MI 48184-1002 | 2020-02-13 |
1083260749 | Justin Roberts | Behavioral Analyst | 600 N 1st St, Las Vegas, NV 89101-1904 | 2019-08-16 |
1881172419 | Justin Roberts | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-08-06 |
1548754054 | Justin Roberts | Dentist | 301 S J T Stites St, Sallisaw, OK 74955-9302 | 2018-06-18 |
1255887915 | Justin Roberts | Spec/Tech, Pathology | 2100 Stantonsburg Rd, Greenville, NC 27834-6028 | 2016-08-31 |
1174978563 | Justin Douglas Roberts | Student in an Organized Health Care Education/Training Program | 355 Grand St, Jersey City, NJ 07302-4321 | 2016-05-04 |
1780047340 | Justin Roberts | Physical Therapist | 4100 Lake Otis Pkwy Ste 106, Anchorage, AK 99508-5230 | 2016-03-31 |
Street Address |
501 WEST PINE STREET |
City | FARMINGTON |
State | MO |
Zip Code | 63640 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740451491 | Farmington Ear, Nose, and Throat, LLC | Clinic/Center | 501 West Pine Street, Farmington, MO 63640 | 2008-03-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
Find all providers in zip 63640 |
Taxonomy Code | 207YS0123X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
Specialization | Facial Plastic Surgery |
An otolaryngologist who specializes in facial plastic surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730170507 | Frank Simo | Otolaryngology | 10448 Old Olive Street Rd Ste 200, Saint Louis, MO 63141-5927 | 2005-11-02 |
1215938550 | Anthony Joseph D'angelo Jr. | Otolaryngology | 2315 Dougherty Ferry Road, Suite 103, St. Louis, MO 63122 | 2005-08-09 |
1265436711 | Robert Daniel Craig | Otolaryngology | 777 S New Ballas Rd, Ste 320e, Saint Louis, MO 63141-8789 | 2005-06-10 |
1154520757 | Nathan Seth Box | Otolaryngology | 1331 W 32nd St, Joplin, MO 64804-1601 | 2007-07-13 |
1023220910 | St Louis University | Otolaryngology | 3660 Vista Ave, Saint Louis, MO 63110-2540 | 2007-05-04 |
1598892838 | William H Friedman | Otolaryngology | 3023 N Ballas Rd, Suite 600d, Saint Louis, MO 63131-2330 | 2007-02-27 |
1609925809 | Tamara Kay Ehlert | Otolaryngology | 522 N New Ballas Rd, Suite 300, Creve Coeur, MO 63141-6857 | 2007-01-09 |
1396810982 | Nayak Plastic Surgery, P.C. | Otolaryngology | 607 S Lindbergh Blvd, Saint Louis, MO 63131-2734 | 2006-11-21 |
1104911288 | Ear Nose & Throat & Plastic Surg Inc | Otolaryngology | 2315 Dougherty Ferry Road, Ste. 103, St. Louis, MO 63122 | 2006-10-04 |
1205825031 | Richard W Maack | Otolaryngology | 226 S Woods Mill Rd, Suite 37 West, Chesterfield, MO 63017-3662 | 2005-10-14 |
Find all providers with the same taxonomy |
City | FARMINGTON |
Zip Code | 63640 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.