Individual
REUBEN WILLIAM AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6799 GREAT OAKS RD, SUITE 250, MEMPHIS, TN 38138-2588
(901) 821-8300
(901) 261-0701
Mailing address
6799 GREAT OAKS RD, SUITE 250, MEMPHIS, TN 38138-2588
(901) 821-8300
(901) 261-0701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD13140
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020052
BLUE CROSS
—
01
—
110001727
RAILROAD MEDICARE
—
05
—
3382217
—
TN
Enumeration date
08/29/2006
Last updated
07/20/2010
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