Individual
JORGE ARTURO CARRASCO AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 705-1272
Mailing address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 705-1272
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2023026703
MO
208M00000X
Hospitalist Physician
Primary
2023026703
MO
Other
Enumeration date
07/23/2020
Last updated
08/01/2023
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