Provider Demographics
NPI:1457575334
Name:BLANCHE, ROBERT V (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:V
Last Name:BLANCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:7865 JEFFERSON HWY
Mailing Address - Street 2:STE D
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1384
Mailing Address - Country:US
Mailing Address - Phone:225-928-2468
Mailing Address - Fax:225-928-2498
Practice Address - Street 1:7865 JEFFERSON HWY
Practice Address - Street 2:STE D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1384
Practice Address - Country:US
Practice Address - Phone:225-928-2468
Practice Address - Fax:225-928-2498
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA161582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1353086Medicaid
LAB62616Medicare UPIN
LA1353086Medicaid