DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JOHN GERARD LILLO, PA

Active Sole Proprietor

MR. JOHN GERARD LILLO, PA is a Physician Assistant healthcare provider located in GRANTS, New Mexico. NPI 1790972644 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · GRANTS, NM

Registration Details

NPI Number
1790972644
Provider Type
Individual
Gender
Male
NPI Issued
Sep 25, 2007 (18.889183078464 yrs)
Last Updated
Sep 25, 2007
License
94PA31 (NM)
Sole Proprietor
Yes

Practice Information

Address
LOBO CANYON RD
WESTERN NEW MEXICO CORRECTIONS
GRANTS, NM, 870200250
Browse NM providers · Browse ZIP 87020
Phone
5058768360
Fax
5058768357
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in GRANTS, NM

Name Credential NPI
JONATHON MICHAEL LAVALLEY PA-C 1871915702
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.