Provider Demographics
NPI:1063518520
Name:AGUILAR, KINDE E (MD)
Entity type:Individual
Prefix:
First Name:KINDE
Middle Name:E
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KINDE
Other - Middle Name:E
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502-0785
Mailing Address - Country:US
Mailing Address - Phone:580-357-9984
Mailing Address - Fax:580-357-3277
Practice Address - Street 1:102 NW 31ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505
Practice Address - Country:US
Practice Address - Phone:580-353-6790
Practice Address - Fax:580-510-7019
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430470207V00000X
OK25503207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200099470AMedicaid
OK200099470AMedicaid
OKOK100155Medicare PIN