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Individual

DR. MALCOLM E ROEBUCK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1801 PINE ST, SUITE 302, MONTGOMERY, AL 36106-0165
(334) 262-7444
Mailing address
1722 PINE ST, STE 503, MONTGOMERY, AL 36106-1103
(334) 270-9914
(334) 270-3195

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10626
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000031424
AL
01
51031424
BLUE CROSS
AL
Enumeration date
01/10/2007
Last updated
05/01/2013
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