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NPI Code Detail

MEDICARE: DR. ROBERT JOSEPH NOLAN PH.D.

MEDICARE: DR. ROBERT JOSEPH NOLAN PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist283AL
2103TA0700XAdult Development & Aging Psychologist283AL
3103TB0200XCognitive & Behavioral Psychologist283AL
4103TC0700XClinical Psychologist283AL
5103TC1900XCounseling Psychologist283AL
6103TC2200XClinical Child & Adolescent Psychologist283AL
7103T00000XPsychologist283AL
8103TF0000XFamily Psychologist283AL
9103TH0100XHealth Service Psychologist283AL
10103TR0400XRehabilitation Psychologist283AL
11103TS0200XSchool Psychologist283AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151071169OTHERALBCBS

General Provider Information

NPI Number : 1225138720
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT JOSEPH NOLAN PH.D.
Provider Business Mailing Address
First Line : 100 WESTSIDE DR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-1908
Country : US
Telephone Number : 334-793-2237
Fax Number : 334-712-6256
Provider Business Practice Location Address
First Line : 100 WESTSIDE DR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-1908
Country : US
Telephone Number : 334-793-2237
Fax Number : 334-712-6256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2006
Last Update Date : 09/11/2025

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