MEDICARE: EDWIN ROMMEL URBI MD

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	LA12660R	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	:	1649264755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWIN ROMMEL URBI MD

Provider Business Mailing Address
First Line	:	6221 GRAND OAK DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-2334
Country	:	US
Telephone Number	:	318-473-1909
Fax Number	:	318-473-1909

Provider Business Practice Location Address
First Line	:	4120 JACKSON STREET EXT
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2752
Country	:	US
Telephone Number	:	318-473-0035
Fax Number	:	318-443-0220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	07/08/2007

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