Individual
DR. JOSE A ATILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1905 W 19TH ST, MOUNTAIN GROVE, MO 65711-1287
(417) 926-1770
(417) 926-1785
Mailing address
2300 HAMMOND MILL LN, WEST PLAINS, MO 65775-6548
(417) 256-2511
(417) 926-1785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
112620
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209187707
—
MO
01
—
26D2006074
CLIA
MO
Enumeration date
09/30/2005
Last updated
04/04/2018
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