Provider Demographics
NPI:1730417148
Name:ROBERTS, PATRICK SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:SCOTT
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 COLEMAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-9667
Mailing Address - Country:US
Mailing Address - Phone:541-227-3266
Mailing Address - Fax:
Practice Address - Street 1:410 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1750
Practice Address - Country:US
Practice Address - Phone:541-482-2904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3968111N00000X
OR1385111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor