Individual
DOUGLAS W AVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 CAISSON HILL ROAD, ATTN:MCXX-CLD-QM (CREDENETIALS), FORT RILEY, KS 66442-5037
(785) 239-5181
(785) 239-7364
Mailing address
600 CAISSON HILL ROAD, ATTN:MCXX-CLD-QM (CREDENETIALS), FORT RILEY, KS 66442-5037
(785) 239-5181
(785) 239-7364
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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