Bacilla, Phillip Ray

Bacilla, Phillip Ray is an individual health care provider with primary practice located at 3351 Masonic Drive , Alexandria LA 71301-3842. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Bacilla, Phillip Ray can be contacted via phone (318) 473-9556.

Contact Information

Primary practice address
3351 Masonic Drive Alexandria LA 71301-3842
Fax: (318) 441-8339
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD 020542 Louisiana
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X MD020542 Louisiana

Profile Details

NPI number 1598732133
LBN Legal business name Bacilla, Phillip Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598732133 NPPES
Louisiana MEDICAID 1662496

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