Basic Information
Provider Information
NPI: 1871796557
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KILPATRICK
FirstName: ROBIN
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5959 S SHERWOOD FOREST BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708166038
CountryCode: US
TelephoneNumber: 2257655727
FaxNumber: 2257659196
Practice Location
Address1: 5428 ODONOVAN DR STE C
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708084387
CountryCode: US
TelephoneNumber: 2253001076
FaxNumber: 2253001080
Other Information
ProviderEnumerationDate: 06/08/2007
LastUpdateDate: 03/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101X020145LAY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

ID Information
IDTypeStateIssuerDescription
192358505LA MEDICAID


Home