Provider Demographics
NPI:1417917782
Name:PILAND, JAY L (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:L
Last Name:PILAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 4TH ST
Mailing Address - Street 2:STE. 5A, BOX 30129
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-448-1249
Mailing Address - Fax:318-448-9644
Practice Address - Street 1:201 4TH ST
Practice Address - Street 2:STE. 5A, BOX 30129
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8421
Practice Address - Country:US
Practice Address - Phone:318-448-1249
Practice Address - Fax:318-448-9644
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022337207RA0401X, 207R00000X, 2083A0300X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1497576Medicaid
110168116OtherRAILROAD MEDICARE
LA1497576Medicaid
110168116OtherRAILROAD MEDICARE