Individual
ROBERT JEROLD JEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4370 W MAIN ST, DOTHAN, AL 36305
(334) 793-5000
(334) 615-8419
Mailing address
PO BOX 6907, DOTHAN, AL 36302-6907
(334) 793-5000
(334) 615-8419
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1033505
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01402209
—
MS
05
—
1772348
—
LA
01
—
2000644
UNITED HEALTHCARE
—
01
—
51515697
BLUE CROSS BLUE SHIELD
AL
01
—
P00059329
RR MEDICARE
—
Enumeration date
03/31/2006
Last updated
07/08/2007
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