# ALICE ROBERT, LLC

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

## Provider details

- **NPI number:** 1740548361
- **Authorized official:** MRS. KELLI D. BEAVERS (CREDENTIALING MANAGER)
- **Authorized official phone:** (318) 325-6200

## Contact information

- **Practice address:** 106 S LINCOLN ST, TALLULAH, LA 71282-4546
- **Practice address phone:** (504) 782-7848
- **Practice address fax:** (318) 574-3900
- **Mailing address:** 106 S LINCOLN ST, TALLULAH, LA 71282-4546
- **Mailing address phone:** (504) 782-7848
- **Mailing address fax:** (318) 574-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MD.025610 | LA | Yes |

## Other

- **Enumeration date:** 05/02/2012
- **Last updated:** 05/02/2012