# DR. JUAN CARLOS CORREA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1508063835
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 0437333 | KS | — |
| 208600000X | Surgery Physician | 2012012809 | MO | — |
| 2086S0129X | Vascular Surgery Physician | 0437333 | KS | Yes |
| 2086S0129X | Vascular Surgery Physician | 2012012809 | MO | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | BS 5741663 | MO | — |

## Other

- **Enumeration date:** 06/29/2007
- **Last updated:** 05/23/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200015710 | — | MO |
| 05 | — | 30004623270001 | — | KS |