Provider Demographics
NPI:1437119070
Name:ROBIN, RICHARD RODNEY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:RODNEY
Last Name:ROBIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SAINT JULIEN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4655
Mailing Address - Country:US
Mailing Address - Phone:337-706-1940
Mailing Address - Fax:337-233-3250
Practice Address - Street 1:309 SAINT JULIEN AVE STE 201
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4655
Practice Address - Country:US
Practice Address - Phone:337-706-1940
Practice Address - Fax:337-233-3250
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.A10379363AM0700X
LAPARXA10379363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1507423Medicaid
970026024OtherRAILROAD MEDICARE
LA1507423Medicaid