Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 27223 | AL |
N | 111NI0900X | Internist | 27223 | AL |
N | 207RC0000X | Internist - Cardiovascular Disease | 27223 | AL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 27223 | AL |
NPI | 1053524686 |
---|---|
Provider Name | Robert Robichaux JR. |
First Address | Mobile, AL 36608-6705 |
Second Address | Mobile, AL 36608-6705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 16/06/2011 |