Provider Demographics
NPI:1053756965
Name:ROBERTSON, RICHARD COVEY JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:COVEY
Last Name:ROBERTSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:141 LAKEVIEW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433
Mailing Address - Country:US
Mailing Address - Phone:985-231-6751
Mailing Address - Fax:985-337-1879
Practice Address - Street 1:141 LAKEVIEW CIRCLE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-231-6751
Practice Address - Fax:985-337-1879
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.207479208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine