Individual
JOSE ERNESTO LOPEZ TABLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 HIGHLAND AVE, HANOVER, PA 17331-2297
(717) 316-3711
(717) 316-3049
Mailing address
300 HIGHLAND AVE, HANOVER, PA 17331-2297
(717) 316-3711
(717) 316-3049
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
82513
SC
208000000X
Pediatrics Physician
MD158669
OR
208000000X
Pediatrics Physician
Primary
MD450276
PA
Other
Enumeration date
07/12/2012
Last updated
02/26/2025
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