Eulogio G Aguilar, MD
Individual provider Active NPI Family Medicine Physician · Fennimore, WI
NPI 1588635239 · NPPES record last updated Feb 12, 2010
Key facts
- NPI
- 1588635239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 27146-20 (WI)
- Practice address
- 220 Lincoln Ave
Fennimore, WI 53809-1030 - Phone
- (608) 822-3737
- Fax
- (608) 882-3738
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27146-020 | WI | MD | Emergency Medicine Physician |
| 27146-20 | WI | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 27146-020 | WI | |
| Family Medicine Physician | 207Q00000X | 27146-20 | WI | Yes |
Addresses
Primary practice location
220 Lincoln Ave
Fennimore, WI 53809-1030
Mailing address
205 Parker St
Boscobel, WI 53805-1642
Phone (608) 375-6217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30696100 | Medicaid | WI |
Other providers in Fennimore, WI
All providers in Fennimore, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.