Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 59182 | MT |
NPI | 1013011626 |
---|---|
Provider Name | Jon D Roebuck |
First Address | Bethesda, MD 20889-0001 |
Second Address | Billings, MT 59101-2710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 17/03/2018 |