Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 322143 | LA |
NPI | 1205255353 |
---|---|
Provider Name | Robert Emmett Reily |
First Address | Baton Rouge, LA 70808-4363 |
Second Address | New Orleans, LA 70118-5240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 28/05/2021 |