Healthcare Provider Details

I. General information

NPI: 1548747702
Provider Name (Legal Business Name): ROBERT SORRELL MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 INDEPENDENCE DR
HOMEWOOD AL
35209-5709
US

IV. Provider business mailing address

833 ST. VINCENT'S DRIVE BUILDING 3, SUITE 403
BIRMINGHAM AL
35205
US

V. Phone/Fax

Practice location:
  • Phone: 205-802-6700
  • Fax:
Mailing address:
  • Phone: 205-939-0447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GRETCHEN POWELL
Title or Position: ASSISTANT ADMINISTRATOR
Credential:
Phone: 205-939-0447