Provider Demographics
NPI:1558489807
Name:BILOG, AGNES OCAMPO (MD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:OCAMPO
Last Name:BILOG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5020 E SHEA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4603
Mailing Address - Country:US
Mailing Address - Phone:480-443-0050
Mailing Address - Fax:480-443-4018
Practice Address - Street 1:5020 E SHEA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4603
Practice Address - Country:US
Practice Address - Phone:480-443-0050
Practice Address - Fax:480-443-4018
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ315582080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics