Provider Demographics
NPI:1821033119
Name:AURA, ALBERT MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:MICHAEL
Last Name:AURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:A MICHAEL
Other - Middle Name:
Other - Last Name:AURA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2400 HOSPITAL DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2385
Mailing Address - Country:US
Mailing Address - Phone:318-212-7990
Mailing Address - Fax:318-212-7995
Practice Address - Street 1:2400 HOSPITAL DR
Practice Address - Street 2:SUITE 130
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2385
Practice Address - Country:US
Practice Address - Phone:318-212-7990
Practice Address - Fax:318-212-7995
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020110207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1918997Medicaid
LAE82392Medicare UPIN
LA5N485F45Medicare PIN