Provider Demographics
NPI:1043227549
Name:ROBELOT, DENISE (PHYSICIAN ASST)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:ROBELOT
Suffix:
Gender:F
Credentials:PHYSICIAN ASST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4326
Mailing Address - Country:US
Mailing Address - Phone:225-246-9301
Mailing Address - Fax:
Practice Address - Street 1:7373 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4326
Practice Address - Country:US
Practice Address - Phone:225-769-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA10392363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
154OtherCLINIC DR #
LA1030937Medicaid
LA5CQ60P937Medicare PIN
LAP32428Medicare UPIN