Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 304635 | LA |
N | 207QS0010X | Family Doctor - Sports Medicine | 304635 | LA |
NPI | 1073991535 |
---|---|
Provider Name | James Michael Robinson |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70808-4333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2015 |
Last Update Date | 08/07/2021 |