Provider Demographics
NPI:1609191212
Name:AUST, TOD ALAN
Entity type:Individual
Prefix:
First Name:TOD
Middle Name:ALAN
Last Name:AUST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 CORPORATE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3147
Mailing Address - Country:US
Mailing Address - Phone:985-377-1884
Mailing Address - Fax:985-377-1914
Practice Address - Street 1:1375 CORPORATE SQUARE DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3147
Practice Address - Country:US
Practice Address - Phone:985-377-1884
Practice Address - Fax:985-377-1914
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208042208VP0014X
LAMD20802207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1609191212OtherBCBSLA