Robertson, William Jerry
Robertson, William Jerry is an individual health care provider with primary practice located at 2604 St Michael Dr Ste 410, Texarkana TX 75503-2378. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Robertson, William Jerry can be contacted via phone (903) 614-5430.Contact Information
Primary practice address
2604 St Michael Dr Ste 410
Texarkana TX 75503-2378
Phone: (903) 614-5430
Fax: (903) 614-5464
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | G0817 | Texas |
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | C5231 | Arkansas |
Profile Details
| NPI number | 1346202579 |
|---|---|
| LBN Legal business name | Robertson, William Jerry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2006 |
| Last updated | Jan 2nd, 2017 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346202579 | NPPES |
| Texas | MEDICAID | 124648002 | |
| Texas | Other | 54444 | |
| Texas | MEDICAID | 103412001 | |
| Texas | MEDICAID | 124648005 |
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