Provider Demographics
NPI:1255352928
Name:BROBST, DONALD (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:BROBST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 CAPITOL COMMERCE BLVD
Mailing Address - Street 2:BLDG A SUITE 250
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-4260
Mailing Address - Country:US
Mailing Address - Phone:334-386-1420
Mailing Address - Fax:334-386-1478
Practice Address - Street 1:1595 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066
Practice Address - Country:US
Practice Address - Phone:334-361-3171
Practice Address - Fax:334-361-3176
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2019-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL18431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51556637BROMedicaid
C48432Medicare UPIN