Provider Demographics
NPI:1780028175
Name:ROBICHAUX, WAYNE THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:THOMAS
Last Name:ROBICHAUX
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 1:12 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-1632
Mailing Address - Country:US
Mailing Address - Phone:985-652-7720
Mailing Address - Fax:
Practice Address - Street 1:12 MUIRFIELD DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-1632
Practice Address - Country:US
Practice Address - Phone:985-652-7720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014315207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services