Ilagan, Petronio

Ilagan, Petronio is an individual health care provider with primary practice located at 3900 St Francis Way Ste 200 , Lafayette IN 47905-4940. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Ilagan, Petronio can be contacted via phone (765) 775-2800.

Contact Information

Primary practice address
3900 St Francis Way Ste 200 Lafayette IN 47905-4940
Phone: (765) 775-2800
Fax: (765) 775-2831
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD425688 Pennsylvania
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 01030521A Indiana

Profile Details

NPI number 1639122047
LBN Legal business name Ilagan, Petronio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Jun 7th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639122047 NPPES
Indiana MEDICAID 100250920
Indiana MEDICAID 1011908700001
Indiana Other 231420CC

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