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Individual

ANIBAL MIKJAIL AVILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 S PARK LN, ALTUS, OK 73521-5731
(580) 379-6140
(580) 379-6149
Mailing address
800 N OKLAHOMA AVE APT 1201, OKLAHOMA CITY, OK 73104-4407
(405) 763-7098

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
36299
OK
207VX0000X
Obstetrics Physician
BP10055824
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200929810A
OK
Enumeration date
04/13/2016
Last updated
06/05/2023
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