Healthcare Provider Details

I. General information

NPI: 1972558328
Provider Name (Legal Business Name): KATRINA L ROBERSON-TRAMMELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 MOFFETT RD
SEMMES AL
36575-5406
US

IV. Provider business mailing address

PO BOX 36258
BELFAST ME
04915-1204
US

V. Phone/Fax

Practice location:
  • Phone: 251-645-8946
  • Fax: 251-645-8976
Mailing address:
  • Phone: 251-318-2678
  • Fax: 251-405-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19407
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: