Provider Demographics
NPI:1336356591
Name:ROBERTSON, ERIN KATHLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:KATHLEEN
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:KATHLEEN
Other - Last Name:WILLIAMS-ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1061 HARMON AVE
Mailing Address - Street 2:SUITE 1D03
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5641
Mailing Address - Country:US
Mailing Address - Phone:912-435-5838
Mailing Address - Fax:912-435-6191
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:SUITE 1D03
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5641
Practice Address - Country:US
Practice Address - Phone:912-435-5838
Practice Address - Fax:912-435-6191
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427047208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice