Provider Demographics
NPI:1275596942
Name:AYLWARD, JOHN JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JAMES
Last Name:AYLWARD
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 1:600 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2156
Mailing Address - Country:US
Mailing Address - Phone:610-948-4298
Mailing Address - Fax:610-948-4331
Practice Address - Street 1:600 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2156
Practice Address - Country:US
Practice Address - Phone:610-948-4298
Practice Address - Fax:610-948-4331
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD205057E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
680089OtherAETNA
PA0026123000OtherKEYSTONE
B33549Medicare UPIN
PA0026123000OtherKEYSTONE