MEDICARE: AMIR HABIBOLLAH AUSEF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	200558	LA
2	207R00000X	Internal Medicine Physician	U5917	TX
3	207R00000X	Internal Medicine Physician	E-16891	AR
4	208100000X	Physical Medicine & Rehabilitation Physician	MD.200558	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00310461	OTHER	LA	RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1528046315	OTHER	LA	NPI

General Provider Information

NPI Number	:	1528046315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIR HABIBOLLAH AUSEF MD

Provider Business Mailing Address
First Line	:	PO BOX 261164
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70826-1164
Country	:	US
Telephone Number	:	225-387-7070
Fax Number	:	225-387-7700

Provider Business Practice Location Address
First Line	:	3600 FLORIDA BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-3842
Country	:	US
Telephone Number	:	225-387-7070
Fax Number	:	225-387-7700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	08/10/2023

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