Diaz, Jose A
Diaz, Jose A is an individual health care provider with primary practice located at 12860 Troxler Ave , Highland IL 62249-2898. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Diaz, Jose A can be contacted via phone (618) 664-9831.Contact Information
Primary practice address
12860 Troxler Ave
Highland IL 62249-2898
Phone: (618) 664-9831
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036.077861 | Illinois |
Profile Details
| NPI number | 1982693271 |
|---|---|
| LBN Legal business name | Diaz, Jose A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2005 |
| Last updated | Nov 8th, 2022 - about 2 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 | 1982693271 | NPPES |
| Illinois | MEDICAID | 036077861 |
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