Provider Demographics
NPI:1487757043
Name:ROIG, RANDOLPH L (MD)
Entity type:Individual
Prefix:DR
First Name:RANDOLPH
Middle Name:L
Last Name:ROIG
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 1:1633 ROBERT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4925
Mailing Address - Country:US
Mailing Address - Phone:504-897-4852
Mailing Address - Fax:
Practice Address - Street 1:2400 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6535
Practice Address - Country:US
Practice Address - Phone:504-507-7693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09912R2081P2900X, 208100000X, 2081P0004X, 2081P0301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAC8865OtherBCBS HMO PROVIDER #
LA721419219001OtherPROVIDER # FOR CIGNA
LA72141921901OtherSTATE GRP PPO/EPO #
LA2395804OtherPROVIDER # UNITED HEALTHC
LA5508255OtherPROVIDER # AETNA PPO/POS
LA1680818Medicaid
LA1680818Medicaid
LA5W800Medicare PIN