MEDICARE: ALTAURUS GEORGE

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1548146491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALTAURUS GEORGE

Provider Business Mailing Address
First Line	:	2647 CROSSWOOD LN
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-5012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2647 CROSSWOOD LN
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-5012
Country	:	US
Telephone Number	:	318-288-6494
Fax Number	:

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

Provider Enumeration Date	:	08/14/2025
Last Update Date	:	08/14/2025

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Directions to “ ALTAURUS GEORGE ” Practice Location

Language	Start Address	Practice Location

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