Provider Demographics
NPI:1982123378
Name:ROBERT, DARRL JR JR (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:MR
First Name:DARRL
Middle Name:JR
Last Name:ROBERT
Suffix:JR
Gender:M
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7605 WESTBANK EXPY STE D
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2367
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7605 WESTBANK EXPY STE D
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2367
Practice Address - Country:US
Practice Address - Phone:504-400-7147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-17
Last Update Date:2017-09-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management