Provider Demographics
NPI:1053488619
Name:GULF COAST SLEEP PROFESSIONALS OF ALABAMA
Entity Type:Organization
Organization Name:GULF COAST SLEEP PROFESSIONALS OF ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:POLYSOMNOGRAPHER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:251-435-5559
Mailing Address - Street 1:4771 BAYOU BLVD # 310
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1930
Mailing Address - Country:US
Mailing Address - Phone:251-380-5713
Mailing Address - Fax:
Practice Address - Street 1:5 MOBILE INFIRMARY CIR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3513
Practice Address - Country:US
Practice Address - Phone:251-435-5559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK719Medicare PIN
DE5446Medicare PIN