Provider Demographics
NPI:1265431597
Name:AGUILAR, DARRYL J (MD)
Entity type:Individual
Prefix:
First Name:DARRYL
Middle Name:J
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3311 PRESCOTT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3983
Mailing Address - Country:US
Mailing Address - Phone:318-442-6767
Mailing Address - Fax:318-441-1359
Practice Address - Street 1:3311 PRESCOTT RD
Practice Address - Street 2:STE 201
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3900
Practice Address - Country:US
Practice Address - Phone:318-442-6767
Practice Address - Fax:318-441-1359
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA13400R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
331030935AGOtherOCHSNER
11674586OtherCAQH
331030935A005OtherTRICARE
LA1428477Medicaid
5H365CD82OtherMEDICARE PART B OF LA
020054512OtherRAILROAD MEDICARE
020054512OtherRAILROAD MEDICARE