Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD441506 | PA |
Y | 208600000X | Surgeon | MD441506 | PA |
N | 2086S0102X | Surgical Critical Care | 190299 | NC |
NPI | 1255592358 |
---|---|
Provider Name | Dr. Joseph Martin Lopez JR. |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes Barre, PA 18711-0027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2008 |
Last Update Date | 31/08/2020 |