Laurence Vernon Ayres, MD

Individual provider Active NPI Anesthesiology Physician · Missoula, MT

NPI 1619002672 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619002672
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
5030 (MT)
Practice address
1605 Snow Bowl Rd
Missoula, MT 59808-9350
Phone
(406) 549-8757
Fax
(406) 549-0263
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5030 MT Yes

Addresses

Primary practice location

1605 Snow Bowl Rd
Missoula, MT 59808-9350

Mailing address

1605 Snowbowl Road
Missoula, MT 59808
Phone (406) 549-8757

Other identifiers

IdentifierTypeStateIssuer
000074321MedicaidMT

Other providers in Missoula, MT

All providers in Missoula, MT · Anesthesiology Physician in Montana

Sources for this page

Verify at the official NPI Registry.