Provider Demographics
NPI:1538336177
Name:DRENNAN, ROBERT HOWARD (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HOWARD
Last Name:DRENNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4176
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-4176
Mailing Address - Country:US
Mailing Address - Phone:985-872-5864
Mailing Address - Fax:985-872-0317
Practice Address - Street 1:8401 PICARDY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3685
Practice Address - Country:US
Practice Address - Phone:225-308-0247
Practice Address - Fax:225-308-0248
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204133207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1040720Medicaid
LA1040720Medicaid