Healthcare Provider Details

I. General information

NPI: 1871545574
Provider Name (Legal Business Name): ROBERT LOUIS POLLOCK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 HOUMA BLVD STE 402
METAIRIE LA
70006-4310
US

IV. Provider business mailing address

3601 HOUMA BLVD STE 402
METAIRIE LA
70006-4310
US

V. Phone/Fax

Practice location:
  • Phone: 504-503-5123
  • Fax: 504-503-5129
Mailing address:
  • Phone: 504-503-5123
  • Fax: 504-503-5129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD018058
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: