Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 23793 | AZ |
N | 207XS0106X | Orthopaedic Hand Surgeon | 23793 | AZ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 23793 | AZ |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 23793 | AZ |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 23793 | AZ |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 23793 | AZ |
NPI | 1356304190 |
---|---|
Provider Name | Dr. Robert Charles Kersey |
First Address | Tucson, AZ 85710-2156 |
Second Address | Tucson, AZ 85710-6157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 05/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
543290 | (05) | AZ |
H16795 | (02) |