Provider Demographics
NPI:1689600850
Name:DE HOYOS, JOSE C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:C
Last Name:DE HOYOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 MERCY WAY
Mailing Address - Street 2:STE 320-330
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4524
Mailing Address - Country:US
Mailing Address - Phone:417-781-5387
Mailing Address - Fax:417-781-7174
Practice Address - Street 1:100 MERCY WAY
Practice Address - Street 2:STE 320-330
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-781-5387
Practice Address - Fax:417-781-7174
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2009033133207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200281960AMedicaid
MO1689600850Medicaid
KS200639790AMedicaid
OK200281960AMedicaid