1861772048 NPI number — ROBERT D TOEPFER PD

Table of content: ROBERT D TOEPFER PD (NPI 1861772048)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861772048 NPI number — ROBERT D TOEPFER PD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOEPFER
Provider First Name:
ROBERT
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TOEPFER
Provider Other First Name:
BOB
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1861772048
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
31696 LA. HWY 22
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70462-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-294-5045
Provider Business Mailing Address Fax Number:
225-294-2142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31696 LA HWY 22
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70462-0010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-294-5045
Provider Business Practice Location Address Fax Number:
225-294-2142
Provider Enumeration Date:
08/19/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  11626 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)