Provider Demographics
NPI:1659356319
Name:HUDDLE, ROBERT MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:HUDDLE
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:P.O. BOX 850849
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0849
Mailing Address - Country:US
Mailing Address - Phone:251-343-5004
Mailing Address - Fax:251-343-5136
Practice Address - Street 1:124A SOUTH UNIVERSITY BLVD.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-343-5004
Practice Address - Fax:251-343-5136
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL06841174400000X
AL6841207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000003084Medicaid
AL51003084OtherBCBS
AL630790569OtherEIN
ALC76948Medicare UPIN
AL51003084OtherBCBS