Provider Demographics
NPI:1336393891
Name:ROBERTS, JESS CLIFTON (MD)
Entity type:Individual
Prefix:DR
First Name:JESS
Middle Name:CLIFTON
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 23666
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225-3666
Mailing Address - Country:US
Mailing Address - Phone:601-200-4749
Mailing Address - Fax:601-200-5929
Practice Address - Street 1:970 LAKELAND DR STE 40
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4640
Practice Address - Country:US
Practice Address - Phone:601-200-4850
Practice Address - Fax:601-200-5929
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS21628207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology