MR. Jorge Luis Lopez, PA

NPI #1104952209 in Fort Carson, Colorado

Provider Information

NPI Number: 1104952209
Entity Type: Individual
Name: MR. Jorge Luis Lopez, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Feb 26, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1650 COCHRANE CIR
Address 2: ATTN CREDENTIALS OFFICE
City: Fort Carson
State: Colorado
ZIP Code: 80913-4603
Phone: (719) 526-7844

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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