Provider Demographics
NPI:1780752444
Name:AUZINE, DONALD PETER (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:PETER
Last Name:AUZINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 S SAINT LANDRY AVE
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-5801
Mailing Address - Country:US
Mailing Address - Phone:225-647-4100
Mailing Address - Fax:224-647-4140
Practice Address - Street 1:3138 S SAINT LANDRY AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-5801
Practice Address - Country:US
Practice Address - Phone:225-647-4100
Practice Address - Fax:224-647-4140
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.025567174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1574741Medicaid
LA1574741Medicaid
LAH94656Medicare UPIN