Individual
MR. JORGE LUIS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1650 COCHRANE CIR, ATTN CREDENTIALS OFFICE, FORT CARSON, CO 80913-4603
(719) 526-7844
(719) 526-7984
Mailing address
EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC, 1650 COCHRANE CIRCLE, ATTN CREDENTIALS OFFICE, COLORADO SPINGS, CO 80913-4604
(719) 526-7844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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