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Individual

DR. JUAN MANUEL LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 W HOSPITAL RD, FORT EISENHOWER, GA 30905-5741
(706) 787-1164
Mailing address
300 W HOSPITAL RD, FORT EISENHOWER, GA 30905-5741
(706) 787-1164

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
74518
GA
208200000X
Plastic Surgery Physician
ME74668
FL

Other

Enumeration date
12/14/2006
Last updated
03/10/2025
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