Provider Demographics
NPI:1982783932
Name:OSTROWE, ALAN J (MD FACA)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:OSTROWE
Suffix:
Gender:M
Credentials:MD FACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 JEFFERSON HWY
Mailing Address - Street 2:# 172
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5858
Mailing Address - Country:US
Mailing Address - Phone:225-766-8680
Mailing Address - Fax:225-766-8511
Practice Address - Street 1:5319 DIDESSE STREET
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4306
Practice Address - Country:US
Practice Address - Phone:225-766-8680
Practice Address - Fax:225-766-8511
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2878R207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Not Answered208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1111422Medicaid
LA1111422Medicaid
LA54478Medicare ID - Type Unspecified