Provider Demographics
NPI:1356517569
Name:DAVID W. AIKEN, M.D., INC.
Entity type:Organization
Organization Name:DAVID W. AIKEN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:AUDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-456-5152
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:SUITE 650
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2933
Mailing Address - Country:US
Mailing Address - Phone:504-456-5152
Mailing Address - Fax:504-456-5019
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:SUITE 650
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-456-5152
Practice Address - Fax:504-456-5019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14608174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1316822Medicaid
LA1316822Medicaid
LA5CE66Medicare PIN