Healthcare Provider Details

I. General information

NPI: 1639190366
Provider Name (Legal Business Name): ROBERT JARRETT KADISH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3106 HOUMA BLVD
METAIRIE LA
70006-5406
US

IV. Provider business mailing address

3106 HOUMA BLVD
METAIRIE LA
70006-5406
US

V. Phone/Fax

Practice location:
  • Phone: 504-833-0029
  • Fax: 504-833-0156
Mailing address:
  • Phone: 504-833-0029
  • Fax: 504-833-0156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPD183R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: