Provider Demographics
NPI:1760681597
Name:AGUILAR, JOSE G (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:G
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-0833
Mailing Address - Fax:515-643-0933
Practice Address - Street 1:1350 DES MOINES ST.
Practice Address - Street 2:STE 110
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-5526
Practice Address - Country:US
Practice Address - Phone:515-643-0833
Practice Address - Fax:515-643-0933
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA37507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine