Individual
PHILLIP AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2121
Mailing address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2121
(262) 741-2178
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
000
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2022
Last updated
06/06/2023
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