Provider Demographics
NPI:1003833021
Name:OSTENDORF, ROBERT E III (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:OSTENDORF
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 GOODYEAR AVE
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1102
Mailing Address - Country:US
Mailing Address - Phone:256-438-5821
Mailing Address - Fax:256-467-4262
Practice Address - Street 1:1026 GOODYEAR AVE
Practice Address - Street 2:SUITE 100B
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1102
Practice Address - Country:US
Practice Address - Phone:256-438-5821
Practice Address - Fax:256-467-4262
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00027282207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology