Healthcare Provider Details

I. General information

NPI: 1811343726
Provider Name (Legal Business Name): ROBERT J RAYMOND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1415 TULANE AVE
NEW ORLEANS LA
70112-2600
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5283
  • Fax:
Mailing address:
  • Phone: 504-988-5283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number306916
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: