MEDICARE: DR. JOSE C ACOL MD

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
1	207Q00000X	Family Medicine Physician	MD419294	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD419294	OTHER	PA	LICENSE

General Provider Information

NPI Number	:	1801890306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE C ACOL MD

Provider Business Mailing Address
First Line	:	601 NORLAND AVE
Second Line	:	SUITE 201
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-4235
Country	:	US
Telephone Number	:	717-263-9555
Fax Number	:	717-217-4218

Provider Business Practice Location Address
First Line	:	504 E RIDGEVILLE BLVD STE 120
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5942
Country	:	US
Telephone Number	:	240-215-6370
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	04/26/2019

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