Provider Demographics
NPI:1659585727
Name:WEILBAECHER INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:WEILBAECHER INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GAGNET
Authorized Official - Last Name:WEILBAECHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:504-885-3272
Mailing Address - Street 1:3800 HOUMA BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4182
Mailing Address - Country:US
Mailing Address - Phone:504-885-3272
Mailing Address - Fax:504-456-6600
Practice Address - Street 1:3800 HOUMA BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4182
Practice Address - Country:US
Practice Address - Phone:504-885-3272
Practice Address - Fax:504-456-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG96653Medicare UPIN