Provider Demographics
NPI:1659487072
Name:ZAMORA, JOSE U II (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:U
Last Name:ZAMORA
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-0629
Mailing Address - Country:US
Mailing Address - Phone:870-235-3209
Mailing Address - Fax:870-466-7577
Practice Address - Street 1:1005 N JACKSON STE C
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2447
Practice Address - Country:US
Practice Address - Phone:870-235-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-17443208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE-17443OtherAR MEDICAL BOARD
CAZZZ70112ZMedicaid
CAZZZ70112ZMedicaid