Provider Demographics
NPI:1598817389
Name:RAU, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:RAU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5619 HIGHWAY 311
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5595
Mailing Address - Country:US
Mailing Address - Phone:985-868-2273
Mailing Address - Fax:985-851-4898
Practice Address - Street 1:5619 HIGHWAY 311
Practice Address - Street 2:SUITE A
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5595
Practice Address - Country:US
Practice Address - Phone:985-868-2273
Practice Address - Fax:985-851-4898
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD017743208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1364959Medicaid
LA55676Medicare PIN
LA1364959Medicaid