Provider Demographics
NPI:1598730004
Name:LAMARTINIERE, RANDY JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:JOSEPH
Last Name:LAMARTINIERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COOPER RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-7731
Mailing Address - Country:US
Mailing Address - Phone:318-623-0170
Mailing Address - Fax:225-410-1181
Practice Address - Street 1:26 COOPER RD UNIT B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-7731
Practice Address - Country:US
Practice Address - Phone:318-623-0170
Practice Address - Fax:225-410-1181
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-19
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.019441208M00000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1398071Medicaid
MS03872754Medicaid
LA5N011Medicare PIN
LA5N0116629Medicare PIN
LAE41262Medicare UPIN