Provider Demographics
NPI:1609876226
Name:OERTLING, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:OERTLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:59125 N PEARL DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-3727
Mailing Address - Country:US
Mailing Address - Phone:985-643-7927
Mailing Address - Fax:985-641-0209
Practice Address - Street 1:59125 N PEARL DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-3727
Practice Address - Country:US
Practice Address - Phone:985-643-7927
Practice Address - Fax:985-641-0209
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA10671R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1990761Medicaid