Provider Demographics
NPI:1174584171
Name:KREUTZMANN, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:KREUTZMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:633 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-1836
Mailing Address - Country:US
Mailing Address - Phone:334-774-7572
Mailing Address - Fax:334-774-6237
Practice Address - Street 1:633 S UNION AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-1836
Practice Address - Country:US
Practice Address - Phone:334-774-7572
Practice Address - Fax:334-774-6237
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21379207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG75629Medicare UPIN