Provider Demographics
NPI:1790725737
Name:BALKAN, ROBERT JAY (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAY
Last Name:BALKAN
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 1:3434 PRYTANIA ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3532
Mailing Address - Country:US
Mailing Address - Phone:504-891-1988
Mailing Address - Fax:504-899-1895
Practice Address - Street 1:3434 PRYTANIA ST
Practice Address - Street 2:SUITE 250
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3532
Practice Address - Country:US
Practice Address - Phone:504-891-1988
Practice Address - Fax:504-899-1895
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15443207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1307271Medicaid
LACI2603OtherRAILROAD MEDICARE
LAB61692Medicare UPIN
B61692Medicare UPIN