| Robin Dale M.d. Llc | |
|
8369 Florida Blvd Ste 5 Denham Springs LA 70726-7862 | |
| (225) 270-8783 | |
| Not Available |
| Full Name | Robin Dale M.d. Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8369 Florida Blvd Ste 5, Denham Springs, Louisiana |
| Authorized Official Name and Position | Robin Barry Dale (PHYSICIAN) |
| Authorized Official Contact | 2252708783 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robin Dale M.d. Llc 8369 Florida Blvd Ste 5 Denham Springs LA 70726-7862 Ph: (225) 270-8783 | Robin Dale M.d. Llc 8369 Florida Blvd Ste 5 Denham Springs LA 70726-7862 Ph: (225) 270-8783 |
| NPI Number | 1053865360 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 08/04/2016 |
| Medicare PECOS PAC ID | 2264728005 |
|---|---|
| Medicare Enrollment ID | O20160906000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053865360 | NPI | - | NPPES |
| 1048445 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 025676 (Louisiana) | Primary |
| Provider Name | Robin B Dale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578594032 PECOS PAC ID: 1153300363 Enrollment ID: I20040720000158 |
| Provider Name | Brooke E Musso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306344379 PECOS PAC ID: 8921360678 Enrollment ID: I20180319000287 |
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