DR. JOHN BOONE ROBERSON NPI 1871607812

NPI Information

DR. John Boone Roberson is an oral and maxillofacial surgery dentist in Hattiesburg, MS. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. John Boone Roberson NPI is 1871607812. 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:

811 SOUTH 28TH AVENUE
HATTIESBURG, MS
ZIP 39402
Phone: (601) 261-2611
Fax: (601) 261-2711

The NPI 1871607812 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/18/2006 and was last updated on 3/7/2012.

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:

Other Identifiers

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

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