Basic Information
| Provider Information | |||||||||
| NPI: | 1073695029 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AGUILAR | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | MATTHEW | ||||||||
| NamePrefix: | |||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 NE 46TH ST | ||||||||
| Address2: | |||||||||
| City: | LAWTON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 735077312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803572794 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4301 MOW-WAY RD | ||||||||
| Address2: | |||||||||
| City: | FORT SILL | ||||||||
| State: | OK | ||||||||
| PostalCode: | 735036300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5804582134 | ||||||||
| FaxNumber: | 5804582314 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 3600 | OK | Y | Chiropractic Providers | Chiropractor |
No ID Information.