Individual
ROBERT E KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10253
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000010714
—
AL
01
—
000010717
BLUE CROSS
AL
01
—
00124502
MISSISSIPPI MEDICAID
MS
05
—
009909415
—
AL
05
—
009936804
—
AL
01
—
010033CC76178
SECTION 1011
AL
01
—
051505965
BLUE CROSS
AL
05
—
051505965
—
AL
01
—
051510728
BLUE CROSS
AL
01
—
051512216
BLUE CROSS
AL
01
—
300032378
RAILROAD MEDICARE
AL
01
—
C76178
VIVA
AL
Enumeration date
06/28/2006
Last updated
07/05/2011
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