Individual
DR. ANGELA RUTH JACKSON-LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
2638 BALLYDOYLE DR, SPRINGFIELD, OH 45503-1171
(937) 244-1846
Mailing address
2638 BALLYDOYLE DR, SPRINGFIELD, OH 45503-1171
(937) 244-1846
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35084279
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2525486
—
OH
Enumeration date
07/05/2005
Last updated
06/16/2025
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