Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 312939 | LA |
NPI | 1508108911 |
---|---|
Provider Name | Benjamin Michael Robichaux |
First Address | Baton Rouge, LA 70810-7827 |
Second Address | Glastonbury, CT 06033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2013 |
Last Update Date | 11/09/2019 |