Provider Demographics
NPI:1457346140
Name:GRUBBE, ROBERT EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EUGENE
Last Name:GRUBBE
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:PO BOX 7190
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-7190
Mailing Address - Country:US
Mailing Address - Phone:256-835-1909
Mailing Address - Fax:256-832-0057
Practice Address - Street 1:912 SNOW ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-1214
Practice Address - Country:US
Practice Address - Phone:256-835-1909
Practice Address - Fax:256-832-0057
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18769207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000045597Medicaid
ALDN4865OtherRAILROAD MEDICARE
AL51045597OtherBLUECROSS AND BLUESHIELD
ALE32826Medicare UPIN
AL000045597Medicaid