Provider Demographics
NPI:1265545701
Name:AWOTWI, JOSEPH D (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:AWOTWI
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:PO BOX 67238
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70896-7238
Mailing Address - Country:US
Mailing Address - Phone:630-734-0200
Mailing Address - Fax:
Practice Address - Street 1:3301 PRESCOTT ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-487-1477
Practice Address - Fax:318-442-5814
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04615R207P00000X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine