1740729656 NPI number — MR. ROBERT SPENCER SAPPINGTON III

Table of content: MR. ROBERT SPENCER SAPPINGTON III (NPI 1740729656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740729656 NPI number — MR. ROBERT SPENCER SAPPINGTON III

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAPPINGTON
Provider First Name:
ROBERT
Provider Middle Name:
SPENCER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
III
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740729656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CAHABA PARK CIR
Provider Second Line Business Mailing Address:
SUITE 114
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-5002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-290-5353
Provider Business Mailing Address Fax Number:
205-449-2322

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 CAHABA PARK CIR
Provider Second Line Business Practice Location Address:
SUITE 114
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-5002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-290-5353
Provider Business Practice Location Address Fax Number:
205-449-2322
Provider Enumeration Date:
02/13/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , with the licence number:  157 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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