Provider Demographics
NPI:1558338186
Name:IBARRA, JOSELUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSELUIS
Middle Name:
Last Name:IBARRA
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:217 HARRISBURG AVE
Mailing Address - Street 2:THE HEART GROUP OF LANCASTER GENERAL HEALTH
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2964
Mailing Address - Country:US
Mailing Address - Phone:717-544-8300
Mailing Address - Fax:717-544-8265
Practice Address - Street 1:217 HARRISBURG AVE
Practice Address - Street 2:THE HEART GROUP OF LANCASTER GENERAL HEALTH
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2964
Practice Address - Country:US
Practice Address - Phone:717-544-8300
Practice Address - Fax:717-544-8265
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2017-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD031424E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010757770004Medicaid
PAC27764Medicare UPIN
PA0010757770004Medicaid