| Altus Neurology P C | |
|
219 E Commerce St Altus OK 73521-3913 | |
| (580) 481-2325 | |
| (580) 482-0091 |
| Full Name | Altus Neurology P C |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 219 E Commerce St, Altus, Oklahoma |
| Authorized Official Name and Position | Juan Ruben Villazon (OWNER) |
| Authorized Official Contact | 5804812325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Altus Neurology P C Po Box 1137 Altus OK 73522-1137 Ph: (580) 481-2325 | Altus Neurology P C 219 E Commerce St Altus OK 73521-3913 Ph: (580) 481-2325 |
| NPI Number | 1780721779 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 12/17/2012 |
| Medicare PECOS PAC ID | 4688718224 |
|---|---|
| Medicare Enrollment ID | O20100219000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780721779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Juan R Villazon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174515605 PECOS PAC ID: 4688718372 Enrollment ID: I20100218000599 |
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