Provider Demographics
NPI:1689659294
Name:STEVENS, ROBERT KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KEITH
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:401 MERIDIAN ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4720
Mailing Address - Country:US
Mailing Address - Phone:256-705-3937
Mailing Address - Fax:256-533-3213
Practice Address - Street 1:401 MERIDIAN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-705-3937
Practice Address - Fax:256-533-3213
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00024072207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1497765721OtherNPI GROUP
AL000007443Medicaid
180044098OtherRAILROAD MEDICARE
H664OtherMEDICARE GROUP PROVIDER
051507443OtherBLUE CROSS BLUE SHIELD
051507443OtherMEDICARE INDIVIDUAL PROV
180044098OtherRAILROAD MEDICARE
H664OtherMEDICARE GROUP PROVIDER