Individual
DR. PATRICIO A ILABACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6027 WALNUT GROVE RD, SUITE 114, MEMPHIS, TN 38120-2145
(901) 683-6161
(901) 683-7998
Mailing address
6027 WALNUT GROVE, SUITE 203, MEMPHIS, TN 38120
(901) 683-6161
(901) 683-3915
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
9582
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015252
—
MS
Enumeration date
05/10/2006
Last updated
10/29/2010
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