MEDICARE: JOSEPH A ACOSTA 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	2084N0400X	Neurology Physician	11263R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710976915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A ACOSTA MD

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-526-0002
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	5247 DIDESSE DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-9153
Country	:	US
Telephone Number	:	225-215-2193
Fax Number	:	225-215-2194

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	08/24/2021

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