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NPI Code Detail

MEDICARE: DR. JAIME BUENAVENTURA PILAR M.D.

MEDICARE: DR. JAIME BUENAVENTURA PILAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianC43219CA
2208600000XSurgery Physician25618VA
3208600000XSurgery Physician27659CO

General Provider Information

NPI Number : 1407852718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAIME BUENAVENTURA PILAR M.D.
Provider Business Mailing Address
First Line : 315 NW RIDGEVIEW WAY
Second Line :
City : LAWTON
State : OK
Zip : 73505-6131
Country : US
Telephone Number : 580-249-1359
Fax Number :
Provider Business Practice Location Address
First Line : 1515 NE LAWRIE TATUM RD
Second Line :
City : LAWTON
State : OK
Zip : 73507-3002
Country : US
Telephone Number : 580-353-0350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 02/25/2008

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