Healthcare Provider Details
I. General information
NPI: 1134142987
Provider Name (Legal Business Name): ROBERT ALLEN SHEARER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/25/2006
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 HILL ST
SPRINGFIELD TN
37172-2951
US
IV. Provider business mailing address
1000 URBAN CENTER DR STE 600
VESTAVIA AL
35242-2584
US
V. Phone/Fax
- Phone: 615-800-8981
- Fax: 615-800-8980
- Phone: 205-208-9312
- Fax: 615-800-8980
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 10243 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | 10243 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: