Healthcare Provider Details

I. General information

NPI: 1508045402
Provider Name (Legal Business Name): ROBERT V. BLANCHE, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 NORTH BLVD STE A
BATON ROUGE LA
70806-3829
US

IV. Provider business mailing address

4040 NORTH BLVD STE A
BATON ROUGE LA
70806-3829
US

V. Phone/Fax

Practice location:
  • Phone: 225-928-2468
  • Fax:
Mailing address:
  • Phone: 225-928-2468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. RANDEE L SILBERFELD
Title or Position: BILLER
Credential:
Phone: 800-650-6334