Individual
JORGE IVAN LOPEZ
Active
Individual
JORGE IVAN LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
17440
AL
2084N0400X
Neurology Physician
28628
WV
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
17440
AL
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
28628
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051113410
BCBS
AL
01
—
051596435
BCBS
AL
01
—
051596437
BCBS
AL
01
—
051596439
BCBS
AL
05
—
107325
—
AL
05
—
107326
—
AL
05
—
107327
—
AL
05
—
125428
—
AL
01
—
P00720170
RAILROAD MEDICARE
AL
Enumeration date
05/05/2006
Last updated
11/24/2021
Update your record
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