MEDICARE: PAUL CARY AGUILLARD 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	207R00000X	Internal Medicine Physician	09731R	LA
2	208000000X	Pediatrics Physician	09731R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871591982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL CARY AGUILLARD M.D.

Provider Business Mailing Address
First Line	:	1702 N BURNSIDE AVE
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-2141
Country	:	US
Telephone Number	:	225-647-8319
Fax Number	:	225-644-5213

Provider Business Practice Location Address
First Line	:	1702 N BURNSIDE AVE
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-2141
Country	:	US
Telephone Number	:	225-647-8319
Fax Number	:	225-644-5213

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	11/16/2010

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