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General NPI Number Information
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NPI Number | 1184288128
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Entity Type | Organization
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Legal Business Name | METAIRIE ORTHOPEDICS & SPORTS MEDICINE
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 3001 DIVISION ST STE 204
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City | METAIRIE
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State | LA
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Zip | 70002-5854
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Country | US
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Telephone | 504-541-5800
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Fax | 504-541-5801
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Provider Business Mailing Address
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Address Line | 3001 DIVISION ST STE 204 STE 204
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City | METAIRIE
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State | LA
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Zip | 70002-5855
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Country | US
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Telephone | 504-541-5800
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Fax | 504-541-5801
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. ROBERT D BOSTICK III
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Credential | MD
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Telephone | 504-541-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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