Provider Demographics
NPI:1952531022
Name:WALDROP, ROBERT III (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WALDROP
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1255 W RIO SALADO PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2816
Mailing Address - Country:US
Mailing Address - Phone:480-962-0071
Mailing Address - Fax:480-962-0590
Practice Address - Street 1:1255 W RIO SALADO PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2816
Practice Address - Country:US
Practice Address - Phone:480-962-0071
Practice Address - Fax:480-962-0590
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ52024207XS0117X
MN58864207X00000X
CAA130744207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ190286Medicare UPIN