Doctor Name: | LOUIS A PAGANO |
NPI Number: | 1114233004 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., ED.S |
License Number: | |
Business Practice Address: | 655 7th St Bldg 700/700-a Robins Afb, GA - 310982227 |
Business Phone Number: | 4783278487 |
Business Fax Number: | |
Mailing Address: | 6080 Lakeview Rd, Apartment 3606 WARNER ROBINS |
State: | GA |
Postal Code: | 310888593 |
Phone Number: | 3173139341 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2010 |
NPI Last Update Date: | 03/30/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |