Botero, Jorge M
Botero, Jorge M is an individual health care provider with primary practice located at 360 Merrimack St Bldg 9, Entrance I, Lawrence MA 01843-1740. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Botero, Jorge M can be contacted via phone (978) 688-6182.Contact Information
Primary practice address
360 Merrimack St Bldg 9, Entrance I
Lawrence MA 01843-1740
Phone: (978) 688-6182
Fax: (978) 689-0731
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 76765 | Massachusetts |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 76765 | Massachusetts |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 9469 | New Hampshire |
Profile Details
| NPI number | 1699758979 |
|---|---|
| LBN Legal business name | Botero, Jorge M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 21st, 2005 |
| Last updated | Nov 25th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699758979 | NPPES |
| New Hampshire | MEDICAID | 3080859 | |
| New Hampshire | MEDICAID | 110052237A |
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