Healthcare Provider Details

I. General information

NPI: 1720124738
Provider Name (Legal Business Name): ROBERT M PRITCHETT M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 10TH AVE S SUITE 400
BIRMINGHAM AL
35205-1200
US

IV. Provider business mailing address

2700 10TH AVE S SUITE 400
BIRMINGHAM AL
35205-1200
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-7710
  • Fax: 205-933-8685
Mailing address:
  • Phone: 205-933-7710
  • Fax: 205-933-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number7094
License Number StateAL

VIII. Authorized Official

Name: ROBERT PRITCHETT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 205-933-7710