1912112517 NPI number — MR. ROBERT PATRICK ROSS ANNETT M.SC.

Table of content: MR. ROBERT PATRICK ROSS ANNETT M.SC. (NPI 1912112517)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912112517 NPI number — MR. ROBERT PATRICK ROSS ANNETT M.SC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANNETT
Provider First Name:
ROBERT
Provider Middle Name:
PATRICK ROSS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.SC.
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:
1912112517
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
#49 52449 RNG. RD. 222
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARDROSSAN
Provider Business Mailing Address State Name:
AB
Provider Business Mailing Address Postal Code:
T8E 2G6
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BOX 297 PROVINCIAL BUILDING
Provider Second Line Business Practice Location Address:
9503 BEAVERHILL ROAD
Provider Business Practice Location Address City Name:
LAC LA BICHE
Provider Business Practice Location Address State Name:
AB
Provider Business Practice Location Address Postal Code:
T0A 2C0
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
780-623-5230
Provider Business Practice Location Address Fax Number:
780-623-5232
Provider Enumeration Date:
05/14/2007

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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