Healthcare Provider Details

I. General information

NPI: 1356929665
Provider Name (Legal Business Name): JOSEPH AGUIRRE III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CAMPBELL LN
BOWLING GREEN KY
42104-4162
US

IV. Provider business mailing address

880 VILLAGE WAY
BOWLING GREEN KY
42103-7838
US

V. Phone/Fax

Practice location:
  • Phone: 270-782-6900
  • Fax:
Mailing address:
  • Phone: 850-259-5554
  • Fax: 943-400-5930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number125.079195
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: