Provider Demographics
NPI:1811958606
Name:ARMSTRONG, RAFAEL BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:BERNARD
Last Name:ARMSTRONG
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 1:3408 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203
Mailing Address - Country:US
Mailing Address - Phone:318-323-2244
Mailing Address - Fax:318-387-9595
Practice Address - Street 1:3408 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-2354
Practice Address - Country:US
Practice Address - Phone:318-323-2244
Practice Address - Fax:318-387-9595
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010503207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1170194Medicaid
B65637Medicare UPIN
LA55161Medicare ID - Type Unspecified