Eduardo Avila, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M-9388 Issued in ID

Practice address

98 Poplar St
Blackfoot, ID 83221-1758

Phone

(208) 782-3993

Fax

(208) 782-3994

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 28, 2008.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1760430367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-3993",
            "fax_number": "208-782-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-782-3993",
            "fax_number": "208-782-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M-9388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OLD",
            "identifier": "75390",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHEILD",
            "identifier": "000010151099",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HB400",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS OLD",
            "identifier": "243412",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "313067",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Eileen Araki, PHARM D
• Damon Taylor Armstrong, D.D.S.
• Candiss L Aschenbrenner, APRN-CNP
• Samantha Paige Averett, LMSW
• Shandra Dee Averett, FNP-C
• Awareness Center for Counseling Inc
• Jennifer Joy Awiah, LCSW
• Jason Michael Bailey, PHARM.D
• Nicole Bair, DPT
• Bald 1 Sleep Solutions LLC

• All providers in Blackfoot, ID
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.