Micaela Jane Dagucon, MD | |
10th Mdg, 4102 Pinon Dr., Usaf Academy, CO 80840-2502 | |
(719) 333-5142 | |
Not Available |
Full Name | Micaela Jane Dagucon |
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Gender | Female |
Speciality | Otolaryngology |
Location | 10th Mdg, Usaf Academy, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396182234 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Y00000X | Otolaryngology | 0101257323 (Virginia) | Primary |
Entity Name | Southwest Medical Associates, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164491072 PECOS PAC ID: 7214831114 Enrollment ID: O20031121000724 |
Mailing Address | Practice Location Address |
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Micaela Jane Dagucon, MD 10th Mdg, 4102 Pinon Dr, Usaf Academy, CO 80840-2502 Ph: (719) 333-5142 | Micaela Jane Dagucon, MD 10th Mdg, 4102 Pinon Dr., Usaf Academy, CO 80840-2502 Ph: (719) 333-5142 |
Jonathan Luke Arnholt, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 4102 Pinion Dr, 10th Medical Group, Usaf Academy, CO 80840 Phone: 719-333-5142 Fax: 719-333-9774 | |
Dr. Nicole Marie Hsu, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 4102 Pinion Dr, 10th Medical Group, Usaf Academy, CO 80840 Phone: 719-333-5142 Fax: 719-333-9774 |