Provider Demographics
NPI:1801340971
Name:ROBERSON, JAMES (HAS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ROBERSON
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7145 CHEVY CHASE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-2610
Mailing Address - Country:US
Mailing Address - Phone:901-758-0010
Mailing Address - Fax:
Practice Address - Street 1:1345 N GERMANTOWN PKWY
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-5959
Practice Address - Country:US
Practice Address - Phone:901-758-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN834237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN834OtherTN HEARING AID SPECIALIST LICENSE NUMBER