Provider Demographics
NPI:1386655967
Name:DECK, ROBERT E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:DECK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4720 S. I-10 SERVICE RD. W
Mailing Address - Street 2:SUITE 206
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1240
Mailing Address - Country:US
Mailing Address - Phone:504-455-7999
Mailing Address - Fax:504-455-7920
Practice Address - Street 1:4720 S. I-10 SERVICE RD. W
Practice Address - Street 2:SUITE 206
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1240
Practice Address - Country:US
Practice Address - Phone:504-455-7999
Practice Address - Fax:504-455-7920
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.014148174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1309320Medicaid
LA160008291OtherRAILROAD MEDICARE
LA4367221000OtherBLUE CROSS
LA721152574OtherTAX IDENTIFICATION
LA0689219OtherAETNA
LA0689219OtherAETNA
LA4367221000OtherBLUE CROSS