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General NPI Number Information
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NPI Number | 1518985563
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Entity Type | Individual
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Provider Name | LUIS R JIMENEZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 8 PROSPECT ST NORTH 2 SPECIALTY
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City | NASHUA
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State | NH
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Zip | 03060-3925
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Country | US
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Telephone | 603-882-8375
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Fax | 603-886-7163
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Provider Business Mailing Address
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Address Line | 8 PROSPECT ST NORTH 2 SPECIALTY
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City | NASHUA
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State | NH
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Zip | 03060-3925
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Country | US
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Telephone | 603-882-8375
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Fax | 603-886-7163
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 14709
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License Number State | NH
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