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General NPI Number Information
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NPI Number | 1134314511
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Entity Type | Individual
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Provider Name | JOSE GREGORIO LOYO-MOLINA MD
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Gender | Male
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 4200 JENNY LIND RD STE. A
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City | FORT SMITH
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State | AR
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Zip | 72901-7632
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Country | US
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Telephone | 479-484-1010
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Fax | 479-573-2740
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Provider Business Mailing Address
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Address Line | 4200 JENNY LIND RD STE. A
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City | FORT SMITH
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State | AR
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Zip | 72901-7632
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Country | US
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Telephone | 479-484-1010
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Fax | 479-573-2740
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | T2007-145
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | E5516
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License Number State | AR
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