Provider Demographics
NPI:1669759122
Name:RACELIS, ROBERT (DVM)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:RACELIS
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HUGHES RD
Mailing Address - Street 2:STE E
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3000
Mailing Address - Country:US
Mailing Address - Phone:256-464-5030
Mailing Address - Fax:256-464-5034
Practice Address - Street 1:34 HUGHES RD
Practice Address - Street 2:STE E
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3000
Practice Address - Country:US
Practice Address - Phone:256-464-5030
Practice Address - Fax:256-464-5034
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5837174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian