Provider Demographics
NPI:1275647745
Name:TREGLE, RODNEY W JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:W
Last Name:TREGLE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3131 NORTH I-10 SERVICE ROAD EAST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-833-7770
Mailing Address - Fax:504-833-7782
Practice Address - Street 1:3131 NORTH I-10 SERVICE ROAD EAST
Practice Address - Street 2:SUITE 308
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-833-7770
Practice Address - Fax:504-833-7782
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA200390207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1091723Medicaid
LA4K223CQ60Medicare PIN