Provider Demographics
NPI:1568570786
Name:PITTS, ROBERT MARSHALL JR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARSHALL
Last Name:PITTS
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2204 LAKESHORE DRIVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209
Mailing Address - Country:US
Mailing Address - Phone:205-874-8300
Mailing Address - Fax:205-874-8333
Practice Address - Street 1:2700 ROGERS DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-870-3520
Practice Address - Fax:205-870-3522
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL549103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R51765Medicare UPIN