Provider Demographics
NPI:1154303246
Name:AKENHEAD, ROBERT BEAUMONT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BEAUMONT
Last Name:AKENHEAD
Suffix:
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 1:2006 FRANKLIN ST SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4551
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL79002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51595619OtherBCBS
AL51595620OtherBCBS
AL009911052Medicaid
AL51595615OtherBCBS
AL83084Medicaid
AL51595618OtherBCBS
AL51595622OtherBCBS
11704203OtherCAQH
AL51067322OtherBCBS
AL51595617OtherBCBS
AL51595886OtherCCI BCBS
AL009942797Medicaid
AL009942797Medicaid