Healthcare Provider Details

I. General information

NPI: 1356377048
Provider Name (Legal Business Name): DOUGLAS E ROBBINS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 STONEHENGE RD
BIRMINGHAM AL
35242-4522
US

IV. Provider business mailing address

4921 STONEHENGE RD
BIRMINGHAM AL
35242-4522
US

V. Phone/Fax

Practice location:
  • Phone: 205-991-0255
  • Fax:
Mailing address:
  • Phone: 205-223-6317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number478
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number478
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number478
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: