Provider Demographics
NPI:1902957111
Name:ROSS, ROBERT L III (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:ROSS
Suffix:III
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11984
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-1984
Mailing Address - Country:US
Mailing Address - Phone:251-431-5800
Mailing Address - Fax:251-431-5810
Practice Address - Street 1:305 N WATER ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-4011
Practice Address - Country:US
Practice Address - Phone:251-433-3781
Practice Address - Fax:251-433-3772
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD110552083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-23094OtherBLUE CROSS PROV ID-WEST
AL515-14917OtherBLUE CROSS PROV ID-DAPHNE
AL510-31570OtherBLUE CROSS PROV ID-IMC
ALC72760Medicare UPIN