Provider Demographics
NPI:1609964055
Name:HOGAN, ROBERT MILTON (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MILTON
Last Name:HOGAN
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 1:4315 HOUMA BLVD
Mailing Address - Street 2:#302
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2940
Mailing Address - Country:US
Mailing Address - Phone:504-454-7800
Mailing Address - Fax:504-454-8924
Practice Address - Street 1:4315 HOUMA BLVD
Practice Address - Street 2:#302
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2940
Practice Address - Country:US
Practice Address - Phone:504-454-7800
Practice Address - Fax:504-454-8924
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014165207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1920240Medicaid
LA1920240Medicaid
LA1920240Medicaid