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Individual

DR. MARTIN AVILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
627 BIENVILLE CIR, NATCHITOCHES, LA 71457-5744
(318) 352-9595
(318) 352-9818
Mailing address
627 BIENVILLE CIR, NATCHITOCHES, LA 71457-5744
(318) 352-9595
(318) 352-9818

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
13467R
LA
207V00000X
Obstetrics & Gynecology Physician
Primary
13467R MD
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1428809
LA
01
1679645071
CORPORATE NPI #
LA
01
174400000X
INDIVIDUAL TAXONOMY#
LA
01
261QM2500X
CORPORATE TAXONOMY CODE
LA
01
28119
CDS#
01
DT5115
MEDICARE RAILROAD GROUP PTAN#
LA
01
MD.13467R
LA STATE MEDICAL EXAMINERS
LA
01
P01153535
MEDICARE RAILROAD PTAN
LA
Enumeration date
06/17/2005
Last updated
03/07/2023
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