Provider Demographics
NPI:1205157591
Name:ROBERTS, ALEXANDER GREGORY (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:GREGORY
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 GUNBARREL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3127
Mailing Address - Country:US
Mailing Address - Phone:423-756-6623
Mailing Address - Fax:423-648-8084
Practice Address - Street 1:1736 GUNBARREL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3127
Practice Address - Country:US
Practice Address - Phone:423-756-6623
Practice Address - Fax:423-648-8084
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50290208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation