Individual
DR. JOSE DIEGO CACERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4301 W MARKHAM STREET, PULMONARY AND CCM, SLOT 555, LITTLE ROCK, AR 72205
(501) 686-5526
(501) 686-7893
Mailing address
4301 W MARKHAM STREET, PULMONARY AND CCM, SLOT 555, LITTLE ROCK, AR 72205
(501) 686-5526
(501) 686-7893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E-11341
AR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
25MA10100300
NJ
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
E-11341
AR
207RP1001X
Pulmonary Disease Physician
25MA10100300
NJ
207RP1001X
Pulmonary Disease Physician
Primary
E-11341
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C00384106406832
DRIVER LICENSE
NJ
Enumeration date
06/08/2012
Last updated
12/18/2020
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