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General NPI Number Information
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NPI Number | 1336218742
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Entity Type | Organization
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Legal Business Name | LUIS S ALONZO MD PA
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 620 W 8TH STREET C/O EDWARDS COUNTY HOSPITAL
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City | KINSLEY
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State | KS
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Zip | 67547-2329
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Country | US
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Telephone | 620-659-3625
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Fax |
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Provider Business Mailing Address
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Address Line | 620 W 8TH STREET C/O EDWARDS COUNTY HOSPITAL
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City | KINSLEY
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State | KS
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Zip | 67547-2329
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Country | US
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Telephone | 620-659-3625
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS S ALONZO
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Credential | MD
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Telephone | 620-728-1664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0800245
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License Number State | KS
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