Individual
ROBERT L TASSIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
119 WHITE STORK DR, SLIDELL, LA 70461-3207
(985) 290-4026
(985) 646-3898
Mailing address
119 WHITE STORK DR, SLIDELL, LA 70461-3207
(985) 290-4026
(985) 646-3898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017359
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121254
—
MS
01
—
13367
LA CDS LICENSE
LA
05
—
1350214
—
LA
01
—
16877
MS MEDICAL LICENSE
MS
01
—
MD.017359
LSBME
LA
Enumeration date
02/20/2008
Last updated
03/07/2023
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