O E Reavill M D, Apmc
Legal Business Name
O E Reavill M D, Apmc
NPI Number
1063432524
NPI Type
Organization
Enumeration Date
07/20/2006
Specialties
(Taxonomies)Code
261QM1300X
261QX0100X
261QP3300X
Primary Taxonomy
No
No
No
Licenses
State
Louisiana
License Number
07184R
Contact
Information
Purpose
Mailing
Location
Address
2501 W PINHOOK RD
2501 W PINHOOK RD
City
Lafayette
Lafayette
State
LA
LA
Postal Code
70508-3346
70508-3346
Country
US
US
Telephone Number
(337) 264-1000
(337) 264-1000
Authorized Official
Name
Dr. Olga Reavill
Title or Position
OWNER
Telephone Number
(337) 264-1000
Identifiers
Identifier
1947164
Identifier State
LA
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/22/2020