Individual
ROBIN LIVELY MARBOURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
308 6TH ST S, SUITE 105, ONEONTA, AL 35121-1846
(205) 625-5520
(205) 625-5522
Mailing address
5170 TRACE CROSSINGS DR, BIRMINGHAM, AL 35244-3954
(205) 985-9484
(205) 985-9371
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-712-TA-055
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000076603
—
AL
05
—
009938093
—
AL
01
—
510-76603
BLUE CROSS & BLUE SHIELD
AL
01
—
515-36833
BLUE CROSS & BLUE SHIELD
AL
01
—
76603
UMWA
AL
01
—
924809
BLOCK VISION
AL
01
—
U18675
VIVA
AL
Enumeration date
07/03/2006
Last updated
05/10/2008
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