Provider Demographics
NPI:1881614865
Name:BRINKMAN, ROBERT II (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BRINKMAN
Suffix:II
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 1:80 GARDENIA DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-9168
Mailing Address - Country:US
Mailing Address - Phone:985-871-5900
Mailing Address - Fax:985-871-5911
Practice Address - Street 1:80 GARDENIA DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-9168
Practice Address - Country:US
Practice Address - Phone:985-871-5900
Practice Address - Fax:985-871-5911
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09988R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1974072Medicaid
LA5R942Medicare PIN
LAF67294Medicare UPIN
LA1974072Medicaid