Provider Demographics
NPI:1336693597
Name:JOSE, JOE (MD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:JOSE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:4301 W MARKHAM ST # 556
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-296-1095
Practice Address - Fax:501-526-5919
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2022-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-151472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology