Healthcare Provider Details

I. General information

NPI: 1902828635
Provider Name (Legal Business Name): ROBERT TALMADGE MAUPIN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OBSTETRICS/GYNECOLOGY 2020 GRAVIER STREET- 7TH FLOOR
NEW ORLEANS LA
70112
US

IV. Provider business mailing address

1340 POYDRAS ST SUITE 1640
NEW ORLEANS LA
70112-1221
US

V. Phone/Fax

Practice location:
  • Phone: 504-412-1527
  • Fax:
Mailing address:
  • Phone: 504-412-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number020778
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number020778
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: