Individual
CHARLES W AYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 RUE DE LA VIE ST, SUITE 100, BATON ROUGE, LA 70817-5126
(225) 201-2000
(225) 201-2110
Mailing address
500 RUE DE LA VIE, SUITE 100, BATON ROUGE, LA 70817-5128
(225) 201-2000
(225) 201-2110
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
014133
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1323675
—
LA
Enumeration date
12/20/2005
Last updated
10/10/2012
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