Healthcare Provider Details

I. General information

NPI: 1073535704
Provider Name (Legal Business Name): ROBERT STEPHEN PERRET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 POYDRAS ST
NEW ORLEANS LA
70112-3701
US

IV. Provider business mailing address

1555 POYDRAS ST
NEW ORLEANS LA
70112-3701
US

V. Phone/Fax

Practice location:
  • Phone: 504-261-6090
  • Fax:
Mailing address:
  • Phone: 504-261-6090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number014781
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number014781
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: