Ilabaca, Patricio A

Ilabaca, Patricio A is an individual health care provider with primary practice located at 6027 Walnut Grove Rd Suite 114, Memphis TN 38120-2145. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Ilabaca, Patricio A can be contacted via phone (901) 683-6161.

Contact Information

Primary practice address
6027 Walnut Grove Rd Suite 114 Memphis TN 38120-2145
Phone: (901) 683-6161
Fax: (901) 683-7998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 9582 Tennessee

Profile Details

NPI number 1255381406
LBN Legal business name Ilabaca, Patricio A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Oct 29th, 2010 - about 14 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 1255381406 NPPES
Mississippi MEDICAID 09015252

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