Individual
DR. JOSE ANTONIO LOPEZ-LAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1015 MEDICAL CENTER PKWY, SELMA, AL 36701-6748
(706) 582-2393
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
00013180
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051556701
—
AL
Enumeration date
05/04/2006
Last updated
02/26/2020
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