Basic Information
Provider Information
NPI: 1306253877
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PABONA
FirstName: JOHN MARK
MiddleName: PASCUA
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 21850
Address2:  
City: HOT SPRINGS
State: AR
PostalCode: 719031850
CountryCode: US
TelephoneNumber: 5016092222
FaxNumber: 5013219689
Practice Location
Address1: 1 MERCY LN STE 404
Address2:  
City: HOT SPRINGS
State: AR
PostalCode: 719136441
CountryCode: US
TelephoneNumber: 5016092222
FaxNumber: 5013219689
Other Information
ProviderEnumerationDate: 07/16/2014
LastUpdateDate: 08/01/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XE-10759ARN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XE-10759ARY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home