Provider Demographics
NPI:1891880928
Name:OLIVER, ROBERT I JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:I
Last Name:OLIVER
Suffix:JR
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 1:2000 STONEGATE TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2246
Mailing Address - Country:US
Mailing Address - Phone:205-298-8660
Mailing Address - Fax:205-298-8664
Practice Address - Street 1:2000 STONEGATE TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2246
Practice Address - Country:US
Practice Address - Phone:205-298-8660
Practice Address - Fax:205-298-8664
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026703174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51543791OtherBCBS OF AL
AL51543792OtherBCBS OF AL
AL51532468OtherBCBS OF AL
AL51545354OtherBCBS OF AL
630697924OtherTAX IDENTIFICATION NUMBER
AL51532469OtherBCBS OF AL
I27982Medicare UPIN
AL51543792OtherBCBS OF AL