Provider Demographics
NPI:1699083188
Name:ROBERT J. AERTKER, III M.D. L.L.C.
Entity type:Organization
Organization Name:ROBERT J. AERTKER, III M.D. L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTERNIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AERTKER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:337-783-4043
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70527-0444
Mailing Address - Country:US
Mailing Address - Phone:337-783-4034
Mailing Address - Fax:337-783-4053
Practice Address - Street 1:136 TOWER RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2211
Practice Address - Country:US
Practice Address - Phone:337-783-4034
Practice Address - Fax:337-783-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.201790261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1500526Medicaid
LA1780877944OtherNPI