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General NPI Number Information
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NPI Number | 1245496439
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Entity Type | Organization
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Legal Business Name | JORGE N. PRIETO,M.D., P.A.
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 1150 N 75TH PL
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City | KANSAS CITY
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State | KS
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Zip | 66112-3302
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Country | US
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Telephone | 913-299-1040
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Fax | 913-299-6622
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Provider Business Mailing Address
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Address Line | 1150 N 75TH PL
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City | KANSAS CITY
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State | KS
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Zip | 66112-3302
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Country | US
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Telephone | 913-299-1040
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Fax | 913-299-6622
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Authorized Official
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Title or Position | M.D.
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Name | DR. JORGE N. PRIETO
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Credential | M.D.
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Telephone | 913-299-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0416843
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License Number State | KS
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