Provider Demographics
NPI:1033211479
Name:CASAMA, ROGELIO A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGELIO
Middle Name:A
Last Name:CASAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70429-0220
Mailing Address - Country:US
Mailing Address - Phone:985-735-8382
Mailing Address - Fax:985-735-9075
Practice Address - Street 1:225 MEMPHIS ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3843
Practice Address - Country:US
Practice Address - Phone:985-735-8382
Practice Address - Fax:985-735-9075
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.011298207R00000X
LAMD011298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1106755Medicaid
LA1106755Medicaid
LA5J487Medicare ID - Type Unspecified