Healthcare Provider Details

I. General information

NPI: 1164633673
Provider Name (Legal Business Name): ADRIAN PAUL AUCOIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8212 SUMMA AVE
BATON LA
70809-0114
US

IV. Provider business mailing address

7777 HENNESSY BLVD STE 301
BATON ROUGE LA
70808-0319
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-4403
  • Fax:
Mailing address:
  • Phone: 225-769-4403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD.202221
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: