Provider Demographics
NPI:1649246802
Name:COWEN, TODD D (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:D
Last Name:COWEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:726 N ACADIA RD
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-5009
Mailing Address - Country:US
Mailing Address - Phone:985-447-9922
Mailing Address - Fax:985-447-9006
Practice Address - Street 1:604 NORTH ACADIA ROAD,
Practice Address - Street 2:SUITE 100
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6712
Practice Address - Country:US
Practice Address - Phone:985-447-9922
Practice Address - Fax:985-447-9006
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2019-03-28
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Provider Licenses
StateLicense IDTaxonomies
LA0213232081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1662879Medicaid
LA1662879Medicaid
LAG07091Medicare UPIN