Basic Information
| Provider Information | |||||||||
| NPI: | 1427412287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | HAYDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 N CAMPBELL AVE | ||||||||
| Address2: | PO BOX 245064 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857245064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206269245 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1609 N WARREN AVE | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857193761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206264024 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2016 | ||||||||
| LastUpdateDate: | 04/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | R75437 | AZ | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.