Provider Demographics
NPI:1285690719
Name:CONDE, JULIET ROBINSON (MD)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:ROBINSON
Last Name:CONDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIET
Other - Middle Name:ARNELL
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1710 DUPLECHIN RD
Mailing Address - Street 2:
Mailing Address - City:CHURCH POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70525-6832
Mailing Address - Country:US
Mailing Address - Phone:337-543-4452
Mailing Address - Fax:
Practice Address - Street 1:3521 HIGHWAY 190
Practice Address - Street 2:SUITE V
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-5135
Practice Address - Country:US
Practice Address - Phone:337-550-0405
Practice Address - Fax:337-550-0409
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.022508207P00000X
LA022508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1497738Medicaid
LA5A868Medicare PIN
LA4A822DB57Medicare PIN
LA1497738Medicaid