Provider Demographics
NPI:1164518205
Name:BURNS, LAVIAS M (MD)
Entity type:Individual
Prefix:DR
First Name:LAVIAS
Middle Name:M
Last Name:BURNS
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 1:7421 JADE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3538
Mailing Address - Country:US
Mailing Address - Phone:618-581-1680
Mailing Address - Fax:
Practice Address - Street 1:15813 PAUL VEGA MD DR STE 200
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1431
Practice Address - Country:US
Practice Address - Phone:985-230-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109909207V00000X
LA325150207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA325150OtherLA LICENSE
IL036109909Medicaid
ILH99910Medicare UPIN