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Individual
ROBERT DOUGLAS BOSTICK III
Active
Individual
ROBERT DOUGLAS BOSTICK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
023026
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1483192
—
LA
01
—
1792217
MEDICAID GROUP
LA
01
—
200045552
RR MEDICARE INDIVIDUAL
LA
01
—
5B353
MEDICARE GROUP
LA
01
—
CK4990
RAILROAD MEDICARE GROUP
LA
Enumeration date
05/10/2006
Last updated
07/29/2019
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