Healthcare Provider Details

I. General information

NPI: 1649270786
Provider Name (Legal Business Name): ROBERT M BOURGEOIS MD MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 KENNETH ST
MORGAN CITY LA
70380-1353
US

IV. Provider business mailing address

1201 KENNETH ST
MORGAN CITY LA
70380-1353
US

V. Phone/Fax

Practice location:
  • Phone: 985-384-3355
  • Fax: 985-384-2884
Mailing address:
  • Phone: 985-384-3355
  • Fax: 985-384-2884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01722
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number017222
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: