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Carl Ray Roberts

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NPI Number Detailed Information

Provider Information:

Name: Carl Ray Roberts
Gender: M
Provider License Number If Given: 25852

NPI Information:

NPI: 1770582207
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 5/13/2015

Provider Business Mailing Address:

Address: 1856 E INNOVATION PARK DR
Oro Valley, AZ 85755
Phone Number: 5208257111
Fax Number: 5208181253

Provider Business Practice Location Address:

Address: 1856 E INNOVATION PARK DR
Oro Valley, AZ 85755
Phone Number: 5208257111
Fax Number: 5208181253

Provider Taxonomy:

Primary: 208D00000X
Secondary (if any):
State: AZ

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