Healthcare Provider Details

I. General information

NPI: 1437168218
Provider Name (Legal Business Name): JOSE A. LOPEZ-ZENO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 04/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FERRY RD NE
ATLANTA GA
30342-1606
US

IV. Provider business mailing address

1000 JOHNSON FERRY RD NE
ATLANTA GA
30342-1606
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8988
  • Fax:
Mailing address:
  • Phone: 404-851-8988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number048794
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: