Provider Demographics
NPI:1952506438
Name:JULIO E.PAJARO, MD, PC
Entity Type:Organization
Organization Name:JULIO E.PAJARO, MD, PC
Other - Org Name:PAJARO PEDIATRICS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAJARO MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-876-2298
Mailing Address - Street 1:PO BOX 951
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31310-0951
Mailing Address - Country:US
Mailing Address - Phone:912-876-2298
Mailing Address - Fax:912-876-2299
Practice Address - Street 1:1763 HWY 196 W
Practice Address - Street 2:E.G. MILES PKWY
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-8013
Practice Address - Country:US
Practice Address - Phone:912-876-2298
Practice Address - Fax:912-876-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035303208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000486571FMedicaid