Provider Demographics
NPI:1316077449
Name:KACHELHOFER, ROBERT DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:KACHELHOFER
Suffix:
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 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:619 19TH ST. SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL256922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051539858OtherBLUE CROSS
AL009941524Medicaid
AL101043Medicaid
AL051539854OtherBLUE CROSS
AL051539856OtherBLUE CROSS
AL051541528Medicaid
AL515-47953OtherBLUE CROSS
AL9531165OtherAETNA
AL009941529Medicaid
AL051539855OtherBLUE CROSS
MS08828590Medicaid
AL174668Medicaid
AL051539857OtherBLUE CROSS
AL009941527Medicaid
AL009941531Medicaid
AL051539859OtherBLUE CROSS
AL511-60814OtherBLUE CROSS
AL009941526Medicaid
AL510I300135Medicare PIN
AL051539856OtherBLUE CROSS