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Organization
BOAZ FAMILY MEDICINE, PC
Active
Organization
BOAZ FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY RUSSELL ROBINSON D. O. (PHYSICIAN)
(256) 840-5800
Entity
Organization
Contact information
Practice address
122 N SNEAD ST, BOAZ, AL 35957-1763
(256) 840-5800
(256) 840-5600
Mailing address
122 N SNEAD ST, BOAZ, AL 35957-1763
(256) 840-5800
(256) 840-5600
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
DO287
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51504831
BLUE CROSS BLUE SHIELD
AL
Enumeration date
12/27/2006
Last updated
08/22/2020
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