Provider Demographics
NPI:1942283940
Name:ROBERTSON, R. CLIO (MD)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:CLIO
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2488 E 81ST ST STE 290
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4265
Mailing Address - Country:US
Mailing Address - Phone:918-494-9341
Mailing Address - Fax:918-494-9355
Practice Address - Street 1:6585 S YALE AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8315
Practice Address - Country:US
Practice Address - Phone:918-481-2767
Practice Address - Fax:918-481-7611
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2020-06-05
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Provider Licenses
StateLicense IDTaxonomies
OK10135207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100191550AMedicaid