Healthcare Provider Details

I. General information

NPI: 1548203235
Provider Name (Legal Business Name): ROBERT MARTIN CONRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 LEIGHTON AVE STE 602
ANNISTON AL
36207-5765
US

IV. Provider business mailing address

PO BOX 18428
HUNTSVILLE AL
35804-8428
US

V. Phone/Fax

Practice location:
  • Phone: 256-238-1011
  • Fax: 256-238-4366
Mailing address:
  • Phone: 256-705-4224
  • Fax: 256-705-4135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number14084
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: