Basic Information
| Provider Information | |||||||||
| NPI: | 1346680758 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBICHAUX | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | MATTHEW | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5959 S SHERWOOD FOREST BLVD | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708166038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2255260011 | ||||||||
| FaxNumber: | 2257659196 | ||||||||
| Practice Location | |||||||||
| Address1: | 17609 OLD JEFFERSON HWY STE C | ||||||||
| Address2: | |||||||||
| City: | PRAIRIEVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2256478511 | ||||||||
| FaxNumber: | 2257432888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2013 | ||||||||
| LastUpdateDate: | 06/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | T-2709 | MS | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 308399 | LA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.