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General NPI Number Information
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NPI Number | 1114563160
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Entity Type | Organization
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Legal Business Name | RICHARD C ROBERTSON JR MD LLC
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 7039 HIGHWAY 190 EAST SERVICE RD STE C
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City | COVINGTON
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State | LA
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Zip | 70433-4961
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Country | US
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Telephone | 985-869-8582
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Fax | 985-888-1838
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Provider Business Mailing Address
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Address Line | 14 DOGWOOD DR
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City | COVINGTON
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State | LA
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Zip | 70433-4433
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Country | US
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Telephone | 601-212-8719
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RICHARD COVEY ROBERTSON JR.
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Credential | MD.207479
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Telephone | 601-212-8719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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