Organization
ROBERT P. BOLLING, MD, LLC
Active
Other names
Southeastern Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT P BOLLING MD (OWNER)
(205) 330-8820
Entity
Organization
Contact information
Practice address
100 TOWNCENTER BLVD STE 111, TUSCALOOSA, AL 35406-1832
(205) 330-8820
(205) 333-2515
Mailing address
PO BOX 1005, FAYETTE, AL 35555-1090
(205) 748-0158
(205) 932-4159
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
24251
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135596
—
AL
01
—
143956
MEDICAID-WINFIELD
AL
01
—
511-21951
BLUE CROSS
AL
01
—
9185060
AETNA
AL
Enumeration date
05/29/2008
Last updated
05/23/2025
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