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NPI Code Detail

MEDICARE: DR. JUAN ESTEBAN PALACIO M.D.

MEDICARE: DR. JUAN ESTEBAN PALACIO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician01048273IN

General Provider Information

NPI Number : 1760467120
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN ESTEBAN PALACIO M.D.
Provider Business Mailing Address
First Line : COMDT (CG-1122), U.S. COAST GUARD
Second Line : 2100 2ND STREET SW SUITE 5314
City : WASHINGTON
State : DC
Zip : 20593-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8501 TANNER WILLIAMS RD
Second Line :
City : MOBILE
State : AL
Zip : 36608-8322
Country : US
Telephone Number : 251-441-6561
Fax Number : 251-441-6415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 02/07/2020

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