Provider Demographics
NPI:1225081177
Name:ALBARES, ROBERT PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PHILIP
Last Name:ALBARES
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 1:480 HONEYSUCKLE RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1156
Mailing Address - Country:US
Mailing Address - Phone:334-836-1212
Mailing Address - Fax:334-836-1888
Practice Address - Street 1:480 HONEYSUCKLE RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1156
Practice Address - Country:US
Practice Address - Phone:334-836-1212
Practice Address - Fax:334-836-1888
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15052207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1200525OtherUNITED HEALTHCARE
P00233455OtherRAILROAD MEDICARE
GA00425741AMedicaid
AL051556205Medicaid
AL051001828OtherBLUE CROSS BLUE SHIELD
AL051581877OtherBLUE CROSS ALABAMA
AL051581877OtherBLUE CROSS ALABAMA
AL051556205Medicare ID - Type Unspecified
ALK486Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
P00233455OtherRAILROAD MEDICARE