Provider Demographics
NPI:1619331659
Name:AGUIAR, CLINTON L (MD)
Entity Type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:L
Last Name:AGUIAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CLINT
Other - Middle Name:
Other - Last Name:AGUIAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1125 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1908
Mailing Address - Country:US
Mailing Address - Phone:479-713-8000
Mailing Address - Fax:479-444-7820
Practice Address - Street 1:1125 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1908
Practice Address - Country:US
Practice Address - Phone:479-713-8000
Practice Address - Fax:479-444-7820
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-11880207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine