Healthcare Provider Details

I. General information

NPI: 1669434676
Provider Name (Legal Business Name): HENRY POSTLETHWAITE ROBSON III M.D., D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SCOTT P ROBSON

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 AL HIGHWAY 157
CULLMAN AL
35058-1571
US

IV. Provider business mailing address

2780 AL HIGHWAY 157
CULLMAN AL
35058-1571
US

V. Phone/Fax

Practice location:
  • Phone: 256-734-9899
  • Fax: 256-734-9899
Mailing address:
  • Phone: 256-734-9899
  • Fax: 256-734-9899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number4735
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number16020
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: