Individual
DR. JOSE LUIS LOPEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6913 N MAIN ST STE 100, GRANGER, IN 46530-8039
(574) 647-8542
(574) 647-8549
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-3245
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01073464A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201214240
—
IN
Enumeration date
05/08/2007
Last updated
01/10/2024
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