Individual
AGRIPPA GAYDEN ROBERT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1434
(985) 230-1682
(985) 230-1617
Mailing address
PO BOX 2668, HAMMOND, LA 70404-2668
(985) 230-1332
(985) 230-1334
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.016278
LA
208000000X
Pediatrics Physician
MD.016278
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00052293
—
MS
05
—
1341754
—
LA
01
—
370008389
RR MEDICARE
—
Enumeration date
07/07/2006
Last updated
09/25/2017
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