Provider Demographics
NPI:1104808351
Name:VROCHER, DIAMOND III (MD)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:
Last Name:VROCHER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:DRAWER 624
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0624
Mailing Address - Country:US
Mailing Address - Phone:205-437-6098
Mailing Address - Fax:205-437-5998
Practice Address - Street 1:1806 SIXTH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-0001
Practice Address - Country:US
Practice Address - Phone:205-975-7389
Practice Address - Fax:205-975-4662
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.25095207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1104808351OtherTRICARE SOUTH
AL515-17086OtherBCBS
AL515-94708OtherBCBS
AL051553551Medicaid
AL106677Medicaid
AL051553551Medicaid
AL1104808351OtherTRICARE SOUTH
AL106677Medicaid
AL051553551Medicare PIN