Roberts, Jeffrey Bennington

Roberts, Jeffrey Bennington is an individual health care provider with primary practice located at 13540 Hull Street Rd , Midlothian VA 23112-2107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Roberts, Jeffrey Bennington can be contacted via phone (804) 739-6142.

Contact Information

Primary practice address
13540 Hull Street Rd Midlothian VA 23112-2107
Phone: (804) 739-6142
Fax: (804) 739-8923
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 0101248946 Virginia
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 2007-00785 North Carolina

Profile Details

NPI number 1770761603
LBN Legal business name Roberts, Jeffrey Bennington
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2008
Last updated Apr 5th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770761603 NPPES
North Carolina MEDICAID 5909191
North Carolina Other C09633

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