Provider Demographics
NPI:1528022753
Name:KNOWLING, ROBERT JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:KNOWLING
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 1:4011 BALMORAL DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6403
Mailing Address - Country:US
Mailing Address - Phone:256-881-4212
Mailing Address - Fax:256-881-4246
Practice Address - Street 1:4011 BALMORAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6403
Practice Address - Country:US
Practice Address - Phone:256-881-4212
Practice Address - Fax:256-881-4246
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000143002086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051027322OtherBLUE CROSS BLUE SHIELD
AL000027322Medicaid
ALF81623Medicare UPIN
AL000027322Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER