Healthcare Provider Details

I. General information

NPI: 1952234593
Provider Name (Legal Business Name): FALLON ROY RPSS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 FILHIOL AVE
MONROE LA
71203-3414
US

IV. Provider business mailing address

2008 FILHIOL AVE
MONROE LA
71203-3414
US

V. Phone/Fax

Practice location:
  • Phone: 318-251-4659
  • Fax: 318-436-3630
Mailing address:
  • Phone: 318-251-4659
  • Fax: 318-436-3630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberOBHPSS1454
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: