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General NPI Number Information
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NPI Number | 1902992092
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Entity Type | Individual
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Provider Name | PAUL M VILLALON-IGLESIAS PA
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 503 N 21ST ST
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City | CAMP HILL
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State | PA
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Zip | 17011-2204
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Country | US
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Telephone | 717-531-5638
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Fax | 717-531-0983
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Provider Business Mailing Address
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Address Line | 500 UNIVERSITY DR MC CA410
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City | HERSHEY
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State | PA
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Zip | 17033-2360
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Country | US
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Telephone | 717-531-5208
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Fax | 717-531-0119
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00085900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA002993L
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License Number State | PA
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