Jorge A Aguilar, MD
Individual provider Active NPI Internal Medicine Physician · Espanola, NM
NPI 1710015433 · NPPES record last updated Jul 16, 2008
Key facts
- NPI
- 1710015433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2000133 (NM)
- Practice address
- 1010 Spruce St
Espanola Hospital
Espanola, NM 87532-2724 - Phone
- (505) 753-7111
- Fax
- (505) 753-4438
- NPI assigned
- Mar 2, 2007
- 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)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000133 | NM | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2000133 | NM | Yes |
Addresses
Primary practice location
1010 Spruce St
Espanola Hospital
Espanola, NM 87532-2724
Mailing address
PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000B1022 | Medicaid | NM |
Other providers in Espanola, NM
- Amanda Abeyta
- Mustapha Kamel Abouda
- Davita Adanuvor
- Adi Shakti Acupuncture Inc.
- Sixto Aguirre
- Rhonda Albin
- Albuquerque Vamc
- Christopher Alcala
- Jessica Lynn Alcon-Romero
All providers in Espanola, NM · Internal Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2008. 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.