# RICHARD C ROBERTSON JR MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114563160
- **Authorized official:** DR. RICHARD COVEY ROBERTSON JR. MD.207479 (MEMBER)
- **Authorized official phone:** (601) 212-8719

## Contact information

- **Practice address:** 7039 HIGHWAY 190 EAST SERVICE RD STE C, COVINGTON, LA 70433-4961
- **Practice address phone:** (985) 869-8582
- **Practice address fax:** (985) 888-1838
- **Mailing address:** 14 DOGWOOD DR, COVINGTON, LA 70433-4433
- **Mailing address phone:** (601) 212-8719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/25/2019
- **Last updated:** 11/25/2019