Provider Demographics
NPI:1477935104
Name:ROBERT G SORRELL MD PC
Entity Type:Organization
Organization Name:ROBERT G SORRELL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:SORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-259-3991
Mailing Address - Street 1:3525 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5709
Mailing Address - Country:US
Mailing Address - Phone:205-259-3991
Mailing Address - Fax:205-683-2468
Practice Address - Street 1:3525 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5709
Practice Address - Country:US
Practice Address - Phone:205-259-3991
Practice Address - Fax:205-683-2468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13563207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty