Provider Demographics
NPI:1215985213
Name:CUMMISKEY, ROBERT DAVID III (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:CUMMISKEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1200 AVENUE G
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3765
Mailing Address - Country:US
Mailing Address - Phone:504-834-0626
Mailing Address - Fax:504-833-9480
Practice Address - Street 1:1200 AVENUE G
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3765
Practice Address - Country:US
Practice Address - Phone:504-349-6713
Practice Address - Fax:504-349-6733
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA022089208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1675181Medicaid
MS09255751Medicaid
LA1675181Medicaid
MS09255751Medicaid