Basic Information
Provider Information
NPI: 1245288513
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGUILAR
FirstName: ROBIN
MiddleName: V.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 EAST BROADWAY
Address2: BOX 50
City: COLUMBIA
State: MO
PostalCode: 652015844
CountryCode: US
TelephoneNumber: 5738158000
FaxNumber: 5738158556
Practice Location
Address1: 1600 EAST BROADWAY
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652015844
CountryCode: US
TelephoneNumber: 5738158000
FaxNumber: 5738158556
Other Information
ProviderEnumerationDate: 05/05/2006
LastUpdateDate: 01/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X153517MAN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RP1001X49062-020WIN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200X2006002441MOY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001X2006002441MON Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207R00000X2006002441MON Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200X153517MAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RC0200X49062-020WIN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

ID Information
IDTypeStateIssuerDescription
20061080605MO MEDICAID


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