Organization
MARTIN AVILES MD A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Natchitoches Women's Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN AVILES MD (OWNER PHYSICIAN)
(318) 352-9595
Entity
Organization
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
261QM2500X
Medical Specialty Clinic/Center
Primary
13567R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417952102
INDIVIDUAL PROVIDER NPI #
LA
01
—
1529877
MEDICAID GROUP PROVIDER ID
LA
01
—
5DF29
GROUP NPI MEDICARE PIN/PTAN
LA
01
—
5H631DF29
MEDICARE GROUP 'MEMBER' PIN/PTAN
LA
01
—
DT5115
MEDICARE RAILROAD
LA
Enumeration date
11/14/2006
Last updated
05/16/2013
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