Provider Demographics
NPI:1417938663
Name:MERKLE, BOBBY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:CHARLES
Last Name:MERKLE
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:PO BOX 739
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:36786-0739
Mailing Address - Country:US
Mailing Address - Phone:334-628-2761
Mailing Address - Fax:
Practice Address - Street 1:1 HAMBURG RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:AL
Practice Address - Zip Code:36786-0739
Practice Address - Country:US
Practice Address - Phone:334-628-2761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3302208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000004320Medicaid
000004320Medicare ID - Type Unspecified
AL000004320Medicaid