Provider Demographics
NPI:1992326763
Name:DESHOTEL, ROBIN MARK (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:MARK
Last Name:DESHOTEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27020 RUFFIN RD
Mailing Address - Street 2:
Mailing Address - City:ELTON
Mailing Address - State:LA
Mailing Address - Zip Code:70532-4300
Mailing Address - Country:US
Mailing Address - Phone:337-523-0530
Mailing Address - Fax:337-246-3946
Practice Address - Street 1:1508 CAJUN DR
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2400
Practice Address - Country:US
Practice Address - Phone:337-468-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-02
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPIC.016723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist