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Individual

DR. ROBERT D. LOLLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1500 ROSS CLARK CIR, DOTHAN, AL 36301-4754
(334) 793-2663
(334) 836-2247
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2247

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
15325
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000675749A
GA
05
000675749B
GA
05
009956315
AL
05
121890
AL
01
511-08299
BCBS OF AL - HEALTHWEST
AL
01
515-21773
BCBS OF AL- 1500 ROSS CLA
AL
Enumeration date
08/15/2005
Last updated
08/21/2019
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