Healthcare Provider Details

I. General information

NPI: 1033112933
Provider Name (Legal Business Name): ROBERT M SUTHERLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924K DAUPHIN ISLAND PKWY
MOBILE AL
36605-3004
US

IV. Provider business mailing address

930 MAR WALT DR SUITE C
FORT WALTON BEACH FL
32547-6606
US

V. Phone/Fax

Practice location:
  • Phone: 850-226-6801
  • Fax: 877-413-5104
Mailing address:
  • Phone: 850-226-6801
  • Fax: 877-413-5104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberL5579
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD.32468
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: