MEDICARE: ROBERT ANCIRA, M.D., A MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	012137	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598036683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT ANCIRA, M.D., A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	1325 AMELIA ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-3625
Country	:	US
Telephone Number	:	504-891-8503
Fax Number	:	504-891-9428

Provider Business Practice Location Address
First Line	:	1325 AMELIA ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-3625
Country	:	US
Telephone Number	:	504-891-8503
Fax Number	:	504-891-9428

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT ANCIRA
Credential	:	M.D.
Telephone Number	:	504-891-8503

Provider Enumeration Date	:	01/20/2012
Last Update Date	:	03/01/2012

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