MR. PAUL ROBERTSON MS RDN LDN NPI 1770718298

NPI Information

NPI: 1770718298
Provider Name: MR. PAUL ROBERTSON, MS, RDN, LDN
Classification: Dietitian, Registered - 133VN1006X
Entity Type: Individual

Specialization: Nutrition, Metabolic

Address:
350 WEST WOODROW WILSON AVENUE
AMBULATORY SERVICES - OUTPATIENT DIETITIAN
JACKSON, MS
ZIP 39213
Phone: (601) 815-2500
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MR. Paul Robertson, MS, RDN, LDN is a nutrition and metabolic dietitian registered in Jackson, MS with 15 years of experience. MR. Paul Robertson, MS, RDN, LDN NPI is 1770718298. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

350 WEST WOODROW WILSON AVENUE
AMBULATORY SERVICES - OUTPATIENT DIETITIAN
JACKSON, MS
ZIP 39213
Phone: (601) 815-2500
Fax: (601) 984-4074

The enumeration date for this NPI number is 5/28/2009 and was last updated on 1/27/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	133VN1006X	Dietitian, Registered	Nutrition, Metabolic	D1361	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	302I717177	MEDICARE PIN	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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