Healthcare Provider Details

I. General information

NPI: 1902957111
Provider Name (Legal Business Name): ROBERT L. ROSS III M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N WATER ST
MOBILE AL
36602-4011
US

IV. Provider business mailing address

PO BOX 11984
BIRMINGHAM AL
35202-1984
US

V. Phone/Fax

Practice location:
  • Phone: 251-433-3781
  • Fax: 251-433-3772
Mailing address:
  • Phone: 251-431-5800
  • Fax: 251-431-5810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD11055
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: