Basic Information
| Provider Information | |||||||||
| NPI: | 1134120355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TON | ||||||||
| FirstName: | ARIEL | ||||||||
| MiddleName: | G.T. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 HOSPITAL DR | ||||||||
| Address2: | STE 420 | ||||||||
| City: | BOSSIER CITY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711112391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3189271110 | ||||||||
| FaxNumber: | 3189271116 | ||||||||
| Practice Location | |||||||||
| Address1: | 104 MORRIS CIR | ||||||||
| Address2: | |||||||||
| City: | HOMER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 710402100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3189271110 | ||||||||
| FaxNumber: | 3189271116 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 03/31/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD200312 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1054372 | 05 | LA | MEDICAID |