Individual
JOSE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 E MAIN ST, ORLEANS, IN 47452
(812) 865-3400
(812) 865-4890
Mailing address
155 E MAIN ST, ORLEANS, IN 47452
(812) 865-3400
(812) 865-4890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01053941A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200531480
—
IN
Enumeration date
10/19/2006
Last updated
10/22/2013
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