Provider Demographics
NPI:1639559255
Name:ROBERTSON, TAYLOR AUGUST (DPM)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:AUGUST
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 GENTILLY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-3854
Mailing Address - Country:US
Mailing Address - Phone:504-323-5251
Mailing Address - Fax:504-383-0594
Practice Address - Street 1:3100 GENTILLY BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-3854
Practice Address - Country:US
Practice Address - Phone:504-323-5251
Practice Address - Fax:504-383-0594
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADPM.200075213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery