Provider Demographics
NPI:1306174073
Name:SONNIER, ROBERT PAUL (PD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PAUL
Last Name:SONNIER
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 OBRIEN DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2926
Mailing Address - Country:US
Mailing Address - Phone:225-266-9546
Mailing Address - Fax:
Practice Address - Street 1:2250 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2707
Practice Address - Country:US
Practice Address - Phone:225-658-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1806277Medicaid