Provider Demographics
NPI:1710468103
Name:AUST MEDICAL LLC
Entity Type:Organization
Organization Name:AUST MEDICAL LLC
Other - Org Name:AUST INTERVENTIONAL PAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOD
Authorized Official - Middle Name:A
Authorized Official - Last Name:AUST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-377-1884
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty