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Individual

ROBERT D BOSTICK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
107 MARYLAND DRIVE, LULING, LA 70070
(504) 349-6411
(504) 349-6415
Mailing address
107 MARYLAND DRIVE, LULING, LA 70070
(504) 349-6411
(504) 349-6415

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
010641
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1118796
LA
Enumeration date
08/10/2005
Last updated
05/03/2026
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