Provider Demographics
NPI:1982710760
Name:ROE, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:ROE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:24980 STATE ST
Mailing Address - Street 2:PO DRAWER 519
Mailing Address - City:ELBERTA
Mailing Address - State:AL
Mailing Address - Zip Code:36530-2573
Mailing Address - Country:US
Mailing Address - Phone:251-986-7301
Mailing Address - Fax:251-986-5927
Practice Address - Street 1:24980 STATE ST
Practice Address - Street 2:PO DRAWER 519
Practice Address - City:ELBERTA
Practice Address - State:AL
Practice Address - Zip Code:36530-2573
Practice Address - Country:US
Practice Address - Phone:251-986-7301
Practice Address - Fax:251-986-5927
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2020-02-20
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Provider Licenses
StateLicense IDTaxonomies
AL27758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL575408OtherUNITED HEALTHCARE
AL51004677OtherBCBS-AL
AL5138245OtherAETNA
ALP00365043OtherRAILROAD MEDICARE PROV#
AL051558395Medicaid
ALC71285OtherHEALTHSPRINGS OF ALABAMA
AL051558395Medicaid
AL575408OtherUNITED HEALTHCARE