Provider Demographics
NPI:1649252503
Name:AGUILAR, AGUSTIN JR (MD)
Entity type:Individual
Prefix:
First Name:AGUSTIN
Middle Name:
Last Name:AGUILAR
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-6360
Mailing Address - Fax:319-384-9184
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-6360
Practice Address - Fax:319-384-9184
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA26545207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA25989OtherWELLMARK BCBS
IA25989OtherWELLMARK BCBS
A03622Medicare UPIN
IA0259895Medicaid