Provider Demographics
NPI:1811011570
Name:ROBERTS, JESSE ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:ANDREW
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2900 CLAY EDWARDS DR
Mailing Address - Street 2:NORTHCARE HOSPICE
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3221
Mailing Address - Country:US
Mailing Address - Phone:816-691-5119
Mailing Address - Fax:816-346-7119
Practice Address - Street 1:2900 CLAY EDWARDS DR
Practice Address - Street 2:NORTHCARE HOSPICE
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3221
Practice Address - Country:US
Practice Address - Phone:816-691-5119
Practice Address - Fax:816-346-7119
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2010-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR5B16207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine