Individual
JOSEPHINE T LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 OGLETHORPE AVE, BLDG 100, ATHENS, GA 30606-2179
(706) 543-9899
(706) 613-3995
Mailing address
1500 OGLETHORPE AVE, BLDG 100, ATHENS, GA 30606-2179
(706) 543-9899
(706) 613-3995
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
044125
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000754839B
—
GA
Enumeration date
04/20/2006
Last updated
10/19/2011
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