Provider Demographics
NPI:1790720514
Name:LAGMAN, ROBERT (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LAGMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 ROSEDOWN WAY
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-8224
Mailing Address - Country:US
Mailing Address - Phone:504-296-6999
Mailing Address - Fax:985-893-2624
Practice Address - Street 1:71121 HIGHWAY 21 STE A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7176
Practice Address - Country:US
Practice Address - Phone:985-809-1464
Practice Address - Fax:985-893-2624
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD0146213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1025054Medicaid
4K713DF75Medicare PIN