Individual
DR. LEO PANTILLA PAJARILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
186 E 2ND AVE STE 100, WILLIAMSON, WV 25661-3602
(304) 236-5902
Mailing address
PO BOX 2080, WILLIAMSON, WV 25661-2080
(304) 236-5902
(304) 235-4049
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
11772
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112030000
—
WV
05
—
64698426
—
KY
Enumeration date
04/18/2007
Last updated
01/05/2024
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