Provider Demographics
NPI:1639101702
Name:ENGLAND, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:ENGLAND
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 1:301 MARIARDEN RD
Mailing Address - Street 2:
Mailing Address - City:DADEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36853-6254
Mailing Address - Country:US
Mailing Address - Phone:256-825-7871
Mailing Address - Fax:256-827-0808
Practice Address - Street 1:301 MARIARDEN RD
Practice Address - Street 2:
Practice Address - City:DADEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36853-6254
Practice Address - Country:US
Practice Address - Phone:256-825-7871
Practice Address - Fax:256-827-0808
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2181207P00000X
AL21821208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL543420006Medicaid
AL000097802OtherMEDICARE
AL000097802OtherMEDICARE
G95339Medicare UPIN