Provider Demographics
NPI:1770547770
Name:THURSTON, ROBERT SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:THURSTON
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 1:3335 CHAPELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2709
Mailing Address - Country:US
Mailing Address - Phone:225-751-3750
Mailing Address - Fax:225-755-0419
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 1008
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-766-0416
Practice Address - Fax:225-769-9212
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07588R208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00019721Medicaid
LA1375535Medicaid
MS00019721Medicaid
LA1375535Medicaid