MEDICARE: JOSEPH D. AWOTWI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	04615R	LA
2	2080P0214X	Pediatric Pulmonology Physician	04615R	LA

General Provider Information

NPI Number	:	1265545701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH D. AWOTWI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 67238
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70896-7238
Country	:	US
Telephone Number	:	630-734-0200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 PRESCOTT ROAD
Second Line	:	SUITE 210
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301
Country	:	US
Telephone Number	:	318-487-1477
Fax Number	:	318-442-5814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/09/2009

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